Abstract

Idiopathic Intracranial Hypertension (IIH) is typically diagnosed with bilateral papilledema. Unilateral papilledema is considered an unusual presentation. A middle-aged obese lady presented with headache and an acute onset of diplopia which was diagnosed to be right-sided lateral rectus palsy. She was not having any positive systemic history. Visual acuity was preserved with OU 6/9 on Snellen's chart. Extraocular movements were restricted. Her anterior segment and fundus evaluation were normal. MRI showed empty sella and prominent optic nerve sheath suggestive of IIH, which was confirmed by MRI Venogram showing delayed transverse sinus filling. IIH was confirmed with high opening pressure of the lumbar puncture. The patient was put on a weight reduction journey and lifestyle modification with oral acetazolamide resulting in improvement of diplopia.