Diseases of the Optic Nerve

If difficulty in fundus diagnosis persists, the following rules may prove valuable: 1) a spontaneous venous pulsation militates strongly against papilledema; 2) serial observations, looking for changes, are more valuable than hasty hasty pronouncements (especially if erroneous); 3) if the patient is otherwise thriving, it is probably not papilledema, 4) if, in the last analysis, a conclusion can not be reached, the course of action should be predicated on other symptoms and signs, as if the fundi could not be visualized.