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Surv Ophthalmol. 2022 Jul-Aug;67(4):1311-1318. doi: 10.1016/j.survophthal.2021.03.006. Epub 2021 Mar 26.


Cerebrospinal fluid (CSF) diversion or shunting procedures are the most commonly performed surgery for the treatment of hydrocephalus and are often employed in the management of elevated intracranial pressure due to a variety of diseases. Despite their popularity however, approximately 50% of shunts fail within the first two years, and several revisions are required within the first decade after placement. Ophthalmologists may encounter patients with a CSF shunt to evaluate for concerns of vision loss or diplopia and to determine if papilledema is present. We discuss the neuro-ophthalmic manifestations and evaluation of possible CSF shunt malfunction.

Keywords: Cerebrospinal fluid; Hydrocephalus; Intracranial pressure; Papilledema; Shunt malfunction; Sixth nerve palsy.

MeSH terms

  • Cerebrospinal Fluid Shunts / methods
  • Humans
  • Hydrocephalus* / complications
  • Hydrocephalus* / surgery
  • Intracranial Hypertension*
  • Papilledema* / diagnosis
  • Papilledema* / etiology
  • Papilledema* / surgery
  • Vision Disorders / surgery