Severe papilledema.
The optic nerve is diffusely elevated with nerve fiber layer edema present 360°. The optic nerve is diffusely hyperemic and there are telangiectatic vessels on the surface of the nerve. There is a flame (splinter) hemorrhage on the temporal aspect of the optic nerve. The retinal vessels are dilated and tortuous, suggestive of venous congestion. The smaller retinal vessels are partially obscured at the edge of the optic nerve but the larger central retinal vessels are still visible. This is characteristic of Frisén grade 3 papilledema.
On an unrelated note, if you look carefully at the pattern of white striae in the retina you can see the different bundles of nerve fibers (arcuate, papillomacular, and nasal) as they course from the retina to the optic nerve.
Image credit: FitzGibbon EJ. EyeWiki. American Academy of Ophthalmology. Accessed 04-11-2019. Available online. Used with permission for educational purposes.
