The disc can be swollen in congestive cardiac failure or in patients with severe chronic emphysema. Marked swelling of the disc with numerous haemorrhages is seen in occlusion of the central retinal vein and this compares with the pale and less haemorrhagic swelling that is seen in anterior ischaemic optic neuropathy. In the latter instance, swelling of the disc occurs in
association with arterial disease and one must take pains to exclude temporal arteritis in the elderly.
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