Severe visual loss associated with idiopathic intracranial hypertension (IIH) in pregnancy

Idiopathic intracranial hypertension (IIH) in pregnancy is often responsive to conservative management and usually carries a favorable prognosis. Pregnant patients may be managed with dietary control, corticosteroid therapy, diuretics, and occasionally serial lumbar puncture. We report an unusual case of permanent visual loss due to IIH in pregnancy, requiring aggressive CSF diversion and bilateral optic nerve sheath fenestration after failure to improve with a brief course of medical management and a lumbar puncture. Despite resolution of the papilledema, the subject’s acuity improved only to 20/40 in the right eye and remained no light perception in the left eye.