In anyone over 50 with sudden visual loss and a swollen optic disc, giant cell arteritis must be excluded before calling it non-arteritic. The fellow eye can be lost within days.
Ask about headache, scalp tenderness, jaw claudication, malaise and weight loss. Check ESR, CRP and platelets the same day, and start high-dose steroids without waiting for biopsy if suspicion is high.
- Ask about headache, jaw claudication, scalp tenderness and systemic symptoms.
- Send ESR, CRP and a full blood count the same day.
- Start high-dose steroids immediately when arteritis is likely; biopsy can follow.
- Arrange temporal artery biopsy or ultrasound within one to two weeks of starting steroids.
Why it matters
Delay risks blindness in the second eye, which steroids can prevent.
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