Visual loss from giant cell arteritis is usually permanent, and the second eye can follow within days. The diagnosis is clinical first, confirmed later.
When the story fits, act before the tests come back.
- Ask every patient over 50 with new visual loss about headache, scalp tenderness, jaw claudication and weight loss.
- Send ESR, CRP and platelet count the same day.
- Start high-dose corticosteroids immediately when clinical suspicion is high; do not wait for biopsy or imaging.
- Arrange temporal artery biopsy or ultrasound within one to two weeks of starting steroids.
- Refer urgently to rheumatology for ongoing care and steroid-sparing treatment.
Why it matters
Delay risks irreversible loss in the second eye, while the confirmatory tests remain valid after steroids start.
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