1 in 38 patients (2.6%) presenting to the emergency department (ED) with a chief complaint of headache, neurologic deficit, visual loss, or elevated blood pressure had optic nerve head edema (ONHE), a recent study found. Identification of ONHE altered patient disposition and contributed to the final diagnosis, confirming the importance of funduscopic examination in the ED. Cross-sectional analysis was done of patients with ONHE in the prospective Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Demographics, neuroimaging results, management, and patient disposition were collected. Researchers found:

• Of 1,408 patients included, 37 (2.6%) had ONHE (median age 31 years, women 27 [73%], black 28 [76%]).
• ONHE was bilateral in 27 of 37 (73%).
• Presenting complaints were headache (18 of 37), visual loss (10 of 37), acute neurologic deficit (4 of 37), elevated blood pressure (2 of 37), and multiple (3 of 37).
• The most common final diagnoses were idiopathic intracranial hypertension (19 of 37), cerebral spinal fluid shunt malfunction/infection (3 of 37), and optic neuritis (3 of 37).