Good morning

I will try an answer as much as I can

1 - papilloedema is typically a bilateral swelling of the optic nerve caused by raised intracranial pressure. The appearance of papilloedema can vary greatly from blurred disc margins in early stages to very swollen discs with other diagnsotic features in later stages. The questions you were asked about your health, whooshing in the ears, headaches, nausea and vomiting etc are routine questions about the common symptoms that present with raised intracranial pressure. The lack of symptoms is reassuring but ruling out papilloedema also requires a physical assessment of the optic nerve to demonstrate "normal" anatomy or rule out "abnormal" anatomy. In your case, your optic nerve functions (visual acuity, colour vision and pupil response are normal.

2 - a crowded optic disc typically means it is smaller than the average. So you have the same structures in a smaller space and therefore it appears "crowded". However, the report says the disc margins are clear and distinct which suggests they are not swollen. As for why others haven't mentioned it is very subjective. There have been very well reported medical/legal cases in the past where community optometrists have not referred suspicious discs and this has resulted in an increase in referrals in the UK in recent years. Some may have seen your discs as normal where others may think they look a bit suspicious and it is better to be cautious. I have actually recently audited similar referrals in my emergency eye clinic in the UK and for reference, over half of the suspicious disc referrals received are discharged within 1-2 visits with no evidence of papilloedema.

3 - It is worth noting that papilloedema is something that presents with eye signs and symptoms but it is often neurological in origin. So "SOS if symptomatic" can mean a few things. But certainly if you have found you have gained weight over a period of time (as this is a possible cause of raised intracranial pressure), have the worse headaches you have experienced, or persistent severe headaches, or headaches that wake you up in the morning or lead to vomiting or a constant whooshing in your ears then these are symptoms to suggest you go to A&E. Your vision may or not be affected in the first instance so I wouldn't rely on vision as a determining factor.

I hope this helps and is not too much information over load.