Calciphylaxis in a Middle-Aged Asian Patient: An Unusual Cause of Disc Swelling

Calciphylaxis resulting in ischemic optic neuropathy secondary to calcification of the central retinal artery is a rare occurrence. Only 12 reports of calciphylaxis resulting in optic neuropathy have been published. While it is important to consider giant cell arteritis (GCA) in cases of acute vision loss with pallid disc swelling, clinicians must also maintain a high index of suspicion of calciphylaxis in a patient with risk factors of hypercalcaemia. We present a 56-year-old lady with end-stage renal failure with acute onset painless right eye vision loss and ipsilateral pallid chalky white swollen optic disc. However, she did not have the other features typical of GCA. Temporal artery biopsy and subsequent skin biopsy of lower limb eschar and indurated dermal plaques found features consistent with calciphylaxis.