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EM@3AM: Papilledema

A 32-year-old female with a previous medical history of acne on isotretinoin presents to the ED for 2 months of headaches that awake her from sleep, more prominent in the morning. She also endorses nausea and vision changes. She notes that her vision is blurry especially in her periphery.  The patient denies the possibility of being pregnant.  She denies fevers, neck stiffness, facial weakness, dysarthria, and personal history of cancer or venous thromboembolic events. Neurologic exam is normal. What’s the next step in your evaluation and treatment?