The aim of this study is to assess the knowledge gap across various specialties and evaluate if there is delay in diagnosis due to incorrect labelling.

Papilledema is the term used to describe optic disc swelling secondary to elevated intracranial pressure (ICP), but many providers use papilledema interchangeably with disc swelling for alternate etiologies that are not associated with elevated ICP.

A retrospective chart review of 368 (287 female, 81 male) eligible patient charts over 18 years of age that had a diagnosis of “unspecified papilledema” (ICD-10 H47. 10) using EPIC Slicer Dicer between June 2021 and September 2023 was performed at University of Kentucky. Computerized tomography, magnetic resonance imaging, and lumbar puncture were used to confirm raised ICP.

Out of 368 patients 42 patients never had any confirmatory tests for elevated ICP for various reasons and were excluded. 151 (46.3%) out of remaining 326 patients labelled as papilledema did not have elevated ICP. We also analyzed data on inaccurate labelling of optic neuropathy as papilledema during the first encounter by various specialties which is as follows: Emergency physicians 27 (17.88%); neurology 22 (15.89%); ophthalmology 21 (13.91%) and other referring providers including primary care 81 (53.65%). In few cases, it took approximately 307 days to reach a final diagnosis from symptom onset.

Our results suggest that inaccurate labelling of optic dis edema as papilledema prevails among various specialties including ophthalmology. We believe there is potential knowledge gap that must be addressed to prevent unnecessary testing, associated system wide costs and erroneous diagnosis that leads to distress among patients.