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Objective To assess the effectiveness, timeliness and adherence to clinical guidelines in the diagnosis and management of Idiopathic Intracranial Hypertension (IIH). Patient outcomes were evaluated to identify areas for improvement in the current care pathways.Background There is currently no standardised referral and follow-up pathway for IIH patients in NHS Tayside.Methods Patients who had a lumbar puncture between May 2023 and May 2024 and whom had been started on treatment for IIH were identified. Those meeting the diagnostic criteria (1) were included in the final analysis.Results There were 17 incident cases of IIH, 14 of which were female. The mean age for the cohort was 28.8 and the mean BMI was 35.5. Pre-diagnostic documentation included visual acuity (100%), fundal examination (100%), visual fields (82.4%), cranial nerve examination (64.7%), blood pressure (29.4%) and papilloedema grade (5.9%). 70.6% underwent venography pre-diagnosis. Patients were documented to have received counselling on weight loss (88.2%) and teratogenic effects of treatment (64.3%). In those with documented visual field status, 21.4% were followed-up within the recommended time intervals.Conclusion This single-centre audit demonstrated an overall need for a revised IIH diagnostic and referral pathway, with a shared neurology and ophthalmology care plan.Reference Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. Journal of Neurology, Neurosurgery & Psychiatry 2018;89:1088-1100.emma.mair4@nhs.scot