Total ophthalmoplegia, optic perineuritis and central retinal artery occlusion secondary to giant cell arteritis: a case report / 国际眼科杂志(Guoji Yanke Zazhi)

A 67-year-old man presented with right sided temporal headache and sudden onset of painless loss of vision in the right eye. It was associated with total ophthalmoplegia with swollen optic disc. ESR and C-reactive protein were elevated. Magnetic resonance imaging demonstrated features of optic perineuritis. The right temporal artery biopsy was normal. The extraocular movements improved with systemic steroids. Unfortunately the patient developed central retinal artery occlusion in the right eye. Total ophthalmoplegia is a rare presentation of giant cell arteritis and initiation of corticosteroids is required for a satisfactory outcome and to prevent blindness of the fellow eye.