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This is actually both horrible and ridiculous. It's horrible that this child had cerebral edema and increased intracranial pressure, but it is also ridiculous to expect and depend on optometrists working at a drug store chain to be the ones to make this diagnosis. Unless you dilate the pupil, and know what you are looking for, you won't find it - especially if you are doing an exam at a drug store where the expectation is likely that you will be doing very basic examinations.

Actually, it used to be standard that when you presented to an ED with significantly elevated blood pressure you would automatically have your optic discs evaluated. In most EDs this rarely happens anymore, so I can't imaging an optometrist in a drug store is going to routinely be looking for this - particularly in an 8 year old. If this poor child had presented to an experienced pediatrician's office, and had complaints that suggested the diagnosis, it might have been made earlier.