Diclofenac-induced papilledema

A 32-year-old female came to the outpatient with complaints of headache. She was taking tablet diclofenac over the counter for the same without proper prescription from the doctor. On examination, anterior segment appeared normal with vision in both eyes 6/9 partial not improving with pinhole. Intraocular pressures were 14 mmHg and 13 mmHg in the right and left eye, respectively. Fundus examination by 90 D slit-lamp biomicroscopy showed blurring of disc margins. On fundus photograph examination, it revealed that the disc margins of both eyes were blurred, indicating grade four papilledema (Frisen papilledema grading system). The patient was administered anti edema measures for her condition and after a month; there were symptomatic improvement with the fundus photography confirming the resolution of papilledema. The patient was advised against nonsteriodial anti-inflammatory drugs in the future as there is a likely chance of the same idiosyncratic reaction, after a thorough systemic work-up was done to rule our other causes of the same.