Papilledema in pseudotumor cerebri.
The right eye demonstrates diffuse nerve fiber layer edema (white feathery appearance) and there is diffuse elevation of the optic nerve. Telangiectatic vessels lie on the surface of the optic nerve (one more prominently seen temporally). The major retinal vessels are obscured by the thickened nerve fiber layer centrally but not completely obliterated by the edema. There are no obvious retinal or choroidal folds. This is characteristic of Frisén grade 4 papilledema.
The left eye demonstrates diffuse nerve fiber layer edema with diffuse elevation of the optic nerve. The disc is hyperemic and there are no obvious telangiectatic vessels. Nasally, there is a thin and faint whitish vertical/circumferential line that most likely indicates the extent of subretinal fluid emanating from the optic nerve. Some of the smaller retinal vessels are obscured by the thickened nerve fiber layer, but the largest retinal vessels remain completely visible. This is characteristic of Frisén grade 3 papilledema.
Image credit: Hoyt WF. Bilateral papilledema with pseudotumor cerebri. Neuro-Ophthalmology Virtual Education Library. University of Utah, 2012. Available online. Used for educational purposes.