How do you work up incidentally found papilledema in the emergency room?  

The term "papilledema" should be reserved for optic disc swelling due to increased intracranial pressure - but I assume that this question is asking what to do if the fundus examination looks abnormal (blurred disc margins perhaps) when there are no visual symptoms or symptoms of increased intracran...

Are you sure it's papilledema? If my experience at the university primary teaching hospital (lacking an ophthalmology dept.) is representative, most "incidentally found papilledema" in the ER is a direct referral from an ophthalmologist, filling the void created by the "demise of direct ophthalmosc...