Use disc appearance together with color vision, visual fields, and pupillary testing to decide whether the patient has true optic neuropathy or pseudo-papilledema. Crowded discs and drusen can mislead the exam unless the functional findings are checked carefully.

AION stands for anterior ischemic optic neuropathy and includes arteritic and non-arteritic forms; A small optic nerve opening can produce a crowded disc appearance; Optic disc drusen and myelinated nerve fibers are common pseudo-papilledema causes; Central scotoma, poor color vision, and an afferent pupillary defect point toward optic nerve disease; Ophthalmoscopy is most useful when the optic nerve head is examined directly