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Unilateral proptosis resulting from giant-cell arteritis
1VA Medical Center, Lake City, Florida, USA.
Journal of the American Optometric Association
|September 15, 1999
Summary
Giant-cell arteritis (GCA) can present unusually with proptosis, a bulging eye. Early diagnosis by eye care providers is crucial for managing GCA and preventing vision loss.
Area of Science:
- Ophthalmology
- Rheumatology
- Vascular Medicine
Background:
- Giant-cell arteritis (GCA) is a systemic inflammatory vasculopathy affecting small- to medium-sized arteries, potentially causing ischemia.
- Inflammation in head and neck arteries, including ophthalmic and posterior ciliary arteries, is common in GCA.
- Ophthalmologists play a key role in diagnosing GCA due to its ocular manifestations.
Observation:
- A 79-year-old male presented with left eye proptosis, vision loss, malaise, and headache.
- Ocular examination revealed exophthalmos and optic nerve pallor.
- Imaging showed orbital inflammatory changes, and lab tests revealed an elevated erythrocyte sedimentation rate.
Findings:
- A diagnosis of GCA was tentatively made and confirmed by temporal artery biopsy.
- This case presented unusually with unilateral proptosis as the primary ocular sign.
- The patient likely experienced prior ocular complications from GCA, including vision loss, which went untreated.
Implications:
- GCA can manifest with diverse ocular symptoms, including proptosis, beyond typical visual disturbances.
- Prompt recognition of atypical GCA presentations by eye care providers is essential.
- Understanding these varied ocular signs aids in timely diagnosis and management of GCA, preventing further complications.