Would you recommend medical therapy for asymptomatic idiopathic intracranial hypertension with completely normal visual field testing?

If this patient has asymptomatic papilledema from idiopathic intracranial hypertension, then I might focus on weight loss first, which can be curative. I would follow her visual fields closely, however, and would have a low threshold to start acetazolamide if any change in her visual fields is noted...

Vision-threatening papilledema is the leading indication for the treatment of intracranial hypertension (IIH). To assess visual function, most clinicians rely on automated (30-2 or 24-2) visual fields or corrected Snellen visual acuity. The latter measures central visual function and is not usually ...