November 8, 2009

Lars Frisen Papilledema grading

Stage 0

Normal disc + blurring of nasal and temporal disc; no obscuration of the vessel + cup is maintained

Stage 1

C shaped blurring of nasal, superior and inferior border

Temporal margin is normal (usually)

Stage 2

Elevation of temporal margin

Stage 3

Elevation of entire disc

Obscuration of retinal vessels at disc margin

Stage 4

Complete obliteration of the cup

Obscuration of retinal vessel on the surface of the disc

Stage 5

Dome shape appearance + all vessels being obscured

Acknowledgement to Dr Gee (Chief MMed Neurosurgery 09)


  1. i just read ur Lars Frisen Papilledema grading of papilloedema, Its very clear and simple! Very good, God bless you, Best wishes for your future!

  2. Hey... Yi Bin's here...
    I think you found this from a website?
    This is the link to Lars' original paper... So there is some mistake... For Stage 0, the original sentence is "A normal optic disc, with blurring of the nasal and temporal disc borders by overlying nerve fibre bundles in inverse proportion to the disc diameter (that is little blurring with large discs, and
    vice versa)."
    In another words, if there is blurring of nasal/temporal border but small, not relatively to disc size, it still consider normal... SO, it doesnt necessary need nasal/temporal blurring for stage 0...
    On the other hand, "Blurring of the upper and lower pole
    areas is disregarded because of the large normal
    variability."... Means if only upper or lower blurring, without significant temporal or nasal involvement, it usually normal variant....

  3. Thanks you Yi Bin.. i will revise the journal again after the end posting exam... thanks for bringing this up.. i really x notice it


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