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[Acute diplopia after the age of 50; always look for giant cell arteritis]

V Daïen1, S Rivière, A Konaté

  • 1Service d'ophtalmologie, CHU de Montpellier, 34295 Montpellier cedex 5. vdaien@hotmail.fr

Journal Francais D'Ophtalmologie
|June 19, 2009
PubMed

Insights

Giant cell arteritis (GCA) can cause ophthalmoplegia, necessitating prompt diagnosis and treatment to prevent vision loss. This case highlights GCA presenting with double vision, successfully treated with oral corticotherapy.

Area of Science:

  • Ophthalmology
  • Rheumatology
  • Neurology

Background:

  • Giant cell arteritis (GCA) is a rare but serious vasculitis affecting medium to large arteries.
  • Ophthalmoplegia, or paralysis of eye muscles, can be a presenting symptom of GCA, potentially leading to vision loss.

Observation:

  • A 59-year-old woman with hypertension and prior thyroid surgery presented with binocular diplopia.
  • Classical GCA symptoms preceded the onset of diplopia, indicating a potential link.

Findings:

  • Diagnosis of GCA was established based on the ophthalmological presentation.
  • Treatment with oral corticotherapy resulted in rapid resolution of headaches and normalization of ocular motility within one month.

Implications:

  • This case underscores the importance of considering GCA in patients with ophthalmoplegia, even with atypical presentations.
  • Early diagnosis and treatment of GCA are crucial for preventing irreversible complications such as vision loss.
  • Ophthalmological signs and the role of temporal artery biopsy in GCA management warrant further discussion.

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