uncommon presentation of idiopathic intracranial hypertension

A 51-year-old gentleman, a known hypertensive on medications presented with transient visual disturbance in his left eye. Examination revealed the presence of unilateral optic disc edema. A lumbar puncture revealed elevated opening pressure with normal cerebrospinal fluid biochemical parameters. Neuroimaging showed no evidence for an alternative cause for intracranial hypertension thus confirming the diagnosis of idiopathic intracranial hypertension (IIH). IIH can rarely present with a unilateral papilledema. This emphasizes the need to meticulously examine both optic fundi in all patients with suspected intracranial hypertension. Early diagnosis of this condition can help in the prevention of permanent visual loss. We hereby report the second case of IIH presenting with a unilateral papilledema in Indian literature.