Challenges in identifying papilledema amid myopic peripapillary atrophy in a patient with idiopathic intracranial hypertension and high myopia: a case report

In highly myopic patients, myopic changes in optic nerve head may obscure papilledema, complicating the diagnosis of IIH. This unusual case highlights the need for detailed history taking and a comprehensive clinical evaluation in patients with high myopia. Clinicians should suspect IIH in the presence of symptoms such as pulsatile tinnitus, morning headache, and visual field constriction, even in the absence of evident papilledema.