REVIEW – January 2020

Ocular damage caused by giant cell arteritis

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Ocular impairment caused by GCA may be very variable ranging from rapid to slow progression of the disease. Patients may present with unspecific complaints which hinder diagnosis and result in consultations from multiple specialties. Patients with rapidly progressing ocular manifestations are usually first seen in the emergency department where diagnosis and treatment may be delayed due to many reasons. Firstly, there are currently no screening tests available in the emergency department setting for GCA. Secondly, because of its low incidence rate, GCA is not something that is first considered in patients with ocular complaints. Furthermore, ocular damage caused by GCA may resolve by itself in some cases and the patient is not instituted for follow-up. Slowly progressing or transient ocular damage caused by GCA is seen by many professionals ranging from ophthalmologist to general practitioner and patients may be given general advice to relieve or observe symptoms. However, patients themselves might miss symptoms and believe them to be passing. For the patient to recieve correct diagnosis involves collaboration between different specialities (emergency physician, general practitioner, ophthalmologist, rheumatologist). Patients who recieve GCA diagnosis must be kept under surveillance by an ophthalmologist as well as by a rheumatologist.