Role of oral fluorescein in the diagnosis of early papilloedema in children.

Nine eyes of suspected papilloedema, 21 with incipient papilloedema, and 16 with pseudopapilloedema in 23 children aged 1 month to 10 years were examined after oral fluorescein. In pseudopapilloedema the retinal vascular fluorescence and slight disc head fluorescence with sharp margins at 30 minutes markedly declined by 60 minutes. These features were similar to our earlier findings with oral fluorescein in the normal fundi of children. Of the 30 eyes with suspected or incipient papilloedema late disc and peripapillary 'staining', polar or diffuse was observed in 12, the 60 minutes fluorescence being more than at 30 minutes in nine and of equal in intensity in three. In these 12 'positive' eyes, and four more of the 18 'negative' eyes, the retinal vascular fluorescence at 60 minutes was significantly more than at 30 minutes. The problems of interpretation after oral fluorescein in the early diagnosis of papilloedema in children and the possible fallacies are discussed.