Purpose: To demonstrate that progressive visual field loss may occur after resolution of papilledema in patients with idiopathic intracranial hypertension and persistently elevated intracranial pressure.
Methods: A patient with idiopathic intracranial hypertension was evaluated with serial Humphrey automated static perimetry after initial treatment and resolution of papilledema.
Results: The patient developed recurrent headache and elevated cerebrospinal fluid pressure. Optic nerve head appearance did not change. Automated perimetry demonstrated reproducible, worsening visual field loss; mean deviation decreased 11 dB in each eye. Visual field defects resolved after optic nerve sheath fenestration.
Conclusions: Increased intracranial pressure caused visual field loss after resolution of papilledema. Optic nerve sheath fenestration improved visual function in this patient.