Which statement best describes papilledema in terms of laterality and appearance on examination?

• A. Unilateral disc edema with pain on eye movement
• B. Rapid unilateral vision loss
• C. Bilateral disc edema with venous engorgement
• D. Pale disc edema

Answer: (C)

Papilledema occurs when intracranial pressure is elevated, so the swelling affects both optic nerves rather than one eye. The typical appearance is swollen and hyperemic discs with blurred margins, and the retinal veins feeding the disc become dilated and tortuous—a sign of venous engorgement from impaired outflow at the optic nerve head. This bilateral, venous-engorged edema contrasts with other patterns: unilateral disc edema with eye movement pain points to optic neuritis; rapid unilateral vision loss suggests an acute vascular or optic neuropathy; pale disc edema indicates chronic optic atrophy or ischemic damage rather than edema from raised intracranial pressure. So the best description of papilledema is bilateral disc edema with venous engorgement.