From photographer to patient in the blink of an eye: incidental optical coherence tomography detection of papilloedema and idiopathic intracranial hypertension during pregnancy

Incidental findings during ophthalmic imaging may reveal clinically significant disease in asymptomatic individuals. Papilloedema, characterised by optic disc swelling secondary to raised intracranial pressure, is a neuro-ophthalmic emergency that can result in permanent visual loss if untreated, making early detection essential. This case report describes the unexpected identification of bilateral optic disc swelling in a clinical/ophthalmic photographer who volunteered as a model patient during optical coherence tomography (OCT) training. Despite being asymptomatic, imaging raised suspicion of papilloedema and prompted urgent same-day assessment. Grade 1 papilloedema was confirmed, and further investigation with MRI and lumbar puncture demonstrated raised intracranial pressure consistent with idiopathic intracranial hypertension (IIH). The patient was four months pregnant, requiring coordinated multidisciplinary care. Treatment with acetazolamide and close monitoring using serial OCT and fundus photography prevented progression and preserved vision. Imaging served not only as a diagnostic tool but also as an effective means of communicating disease status across specialties and to the patient. This case reflects the dual perspective of healthcare professional and patient, highlighting the value of routine ophthalmic imaging, rapid referral pathways, and the role of visual communication in modern medicine. Incidental imaging findings, even in low-risk settings, may be sight-saving and life-altering.