Total right visual loss due to Temporal Arteritis recognised only after left visual deterioration, necessitating maximal steroid therapy and tocilizumab

Background

Temporal Arteritis is the most common panarteritis in adults and typically affects elderly people, particularly women. This occlusive vasculitis is associated with at least 51 symptoms and signs and can result in bilateral blindness and potentially death from aortic root dilatation and rupture.

Case Report

This report demonstrates a case of Temporal Arteritis with bilateral, rapidly progressive arteritic anterior ischaemic optic neuropathy despite recommended high dose oral steroid therapy, with right eye blindness only recognised after left visual loss developed. The addition of tocilizumab was required for resolution of the symptoms.

Conclusions

It is essential to examine thoroughly all the parameters of visual function in a patient who has lost vision. Such an examination, especially in patients with TA, consists as a minimum of visual acuity, pupil reactions, confrontation fields and fundi in both eyes in every patient.