Course: Sound Optometry: Episode 9 - Suspicious Discs: When is a disc a disc at risk?

Section

General

Domains: Clinical Practice, Communication

No CPD Points

Welcome to Sound Optometry, a podcast from Docet hosted by Michelle Hanratty, an IP optometrist with over 20 years’ experience in both high street and hospital settings. Each month, through case studies and in-depth conversations, we explore the topics that matter most to you as an optometrist and are relevant to everyday practice.

Episode 9 - Suspicious Discs: When is a disc a disc at risk?

In this episode, we explore a clinical case in which idiopathic intracranial hypertension resulted in severe visual symptoms and bilateral optic disc swelling. Michelle Hanratty then discusses the key features of papilloedema, including its presentation, underlying causes and differential diagnoses, with neuro-ophthalmologist Dr Denize Atan.

The second part of the episode examines the unilateral causes of optic disc swelling. Dr Atan discusses the key features of optic neuropathies and highlights how their symptoms and clinical findings differ from those of papilloedema. The episode concludes with practical advice for optometrists on the appropriate referral of affected patients.

Subscribe to the series on your preferred podcast player so you don’t miss an episode. You can access all episodes of Sound Optometry here.

First published: April 2021
Last reviewed: February 2026

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Learning outcomes

Communication

s.1 Listen to patients and ensure they are at the heart of decisions made about their care

Able to elicit the detail of significant symptoms relating to optic disc swelling.

Clinical practice

s.5 Keep your knowledge and skills up to date

Knowledge about the symptoms and signs of neurological significance to differentially diagnose causes of optic disc swelling.

s.7 Conduct appropriate assessments, examinations, treatments and referrals

Able to interpret and investigate the presenting symptoms of a patient with suspicious optic discs.

Able to develop a management plan within a primary care setting for the investigation of a patient with suspicious optic discs and able to interpret the results.

Unit 1 - Suspicious discs audio track (~25 min)

Audio track
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Key Points

Papilloedema case presentation
Clinical features of papilloedema and pseudopapilloedema
Potential causes and presenting symptoms of unilateral disc swelling
Referral for suspicious optic discs.

Unit 2 - Required reading (~25 min)

More information

References
URLCollege of Optometrists. Working with colleagues. Referrals. Guidance for Professional Practice. Communication, partnership and teamwork. [Accessed Feb 2026] URL Opens in a new window.
URLHata M, Miyamoto K (2017) Causes and Prognosis of Unilateral and Bilateral Optic Disc Swelling. Neuroophthalmology; 41(4), pp 187-191 [Accessed Feb 2026] URL Opens in a new window.
URLMollan S, Markey K, Benzimra J et al. (2014) A practical approach to, diagnosis, assessment and management of idiopathic intracranial hypertension. Practical Neurology; 14, pp 380-390 [Accessed Feb 2026] URL Opens in a new window.
URLStephenson M (2010) Diagnosing and Managing Ischemic Optic Neuropathy. Review of Ophthalmology. [Accessed Feb 2026] URL Opens in a new window.
URLVoss E, Raab P, Trebst C, et al. (2011) Clinical approach to optic neuritis: pitfalls, red flags and differential diagnosis. Ther Adv Neurol Disord; 4(2), pp 123-134 [Accessed Feb 2026] URL Opens in a new window.
Docet would like to thank the following for their contribution to this programme:
Dr Denize Atan, Consultant in Neuro-ophthalmology – University of Bristol & Bristol Eye Hospital.

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