Optometrist and my GCA

[prunus]

Is it possible to have GCA when there is nothing showing in your eyes? Would be very grateful if someone can educate me in the matter.

[SnazzyD]

Well, I had full blown symptoms with my eyesight shutting down and nothing showed up in my eyes. However, my eyes were looked at about 3 hours post 60mg Pred which had had a miraculous effect. Also, the exam didn’t involve a lot of equipment and it flared up very quickly. My guess is that the optic nerve was being starved of circulation by an acute inflammation that wasn’t yet showing up as a visible feature and was very quickly countered by the Pred, but I’m no doctor. I’ve seen a few times on this forum where people say their Ophalmologist says they don’t have GCA because their eyes look ok. Firstly, I have never read that an eye exam is the go-to method of diagnosis and secondly, GCA may affect other cranial arteries and not the one feeding the optic nerve, so an eye exam wouldn’t be useful in that case.

[prunus in reply to SnazzyD]

Your reply has given me food for thought. I had GCA 6 years ago and had been in remission until a year last January. I have got the pred down again but feel something is not quite right in my head. Not sure how to proceed.

[jinasc]

pmr-gca-northeast.org.uk/us...

Follow the above link and then read up on the Diagnosis and Treatment of GCA issued by the BSR. It may help you to understand more about GCA. Knowledge is power.

I had, one sided headache, jaw claudication (ie pain when eating) and loss of balance.....I had no problem with my vision as I thought. I was wrong, my spatial awareness was impaired which was how I had miscalculated the space between a chair and stairs and fell down the stairs.

Opthathmologists are trained up on GCA, more so than medics. This is because if left untreated and you lose total or partial sight then that is it - no getting it back.

My optician (Specsavers - Bridget trained at Belfast Uni) spotted I had GCA she told me she was picking up the phone and sending me to A&E right now and she would warn A&E I was arriving and needed immediate treatment.

I already knew as I had been diagnosed 2 weeks previously but never thought to mention it to her. I just wanted new glasses. I then went every 6 months for check-ups, which at that time were in place, free of charge, for GCA. Needless to say, that has gone with other cuts.

[prunus in reply to jinasc]

Many thanks for your helpful comments.

[Primarose]

I was sent to the eye hospital by the senior practise nurse with suspected GCA. This was in early December 2016.

On examination the doctor told me that there was nothing wrong and sent me away with a flea in my ear for time wasting, telling me that I was grinding my teeth.

Consequently because the eye hospital said that I didn't have GCA all the other hospital departments were puzzled by my symptoms.

In January 2017 on a home visit my doctor took bloods, I was told to get to A & E ASAP. By all accounts if he hadn't taken the bloods when he did I would not be here now.

A percentage of patients do have sight loss but it is by no means the only symptom of GCA which, unfortunately the eye hospital, (in my case) wrongly suggested. None of my others symptoms were taken into consideration at the eye hospital and I had many of the classic symptoms of GCA except for sight loss.

[Marijo1951]

I had the strange head aches and stiff jaw, but no obvious effects on my eyes. My GCA was confirmed by a biopsy the day after it was diagnosed.

[Sho-Sho]

I was diagnosed with GCA two years ago and had a Temporal Biopsy which was positive - my symptoms were cracking headaches, generally feeling very unwell and weight loss, but I never had any visual problems. So the answer is yes.

Good luck.

[Telian]

It doesn't always show up with an eye test on the high street or the hospital, but it doesn't mean you haven't got GCA. Don't ignore symptoms of headaches like no other that don't respond to painkillers, painful jaw when eating, teeth aching numbness on the affected side and more importantly any visual disturbance. I had all of these and had a negative TAB but a positive Ultra Sound. Symptoms mean more than blood tests too, don't ignore them. After 4 1/2 years my eyes have not been affected by the GCA, except for cataracts, yet I temporarily lost my sight prior to diagnosis. If you have any sign of visual disturbance go to A&E.

[prunus in reply to Telian]

I had the TAB six years ago and the result was positive, which confirmed the diagnosis. The present problems started a year last January but I have a disabled husband too.

[Telian]

I know what you are going through - it all gets too much sometimes doesn't it - I'm told it's important to take some time for myself, which I try to do when I can! Hope you do too...

[prunus in reply to Telian]

Yes it does. I try to space things but it doesn't always work like that. The best made plans of mice and men ..........

[Dream21]

My eye exams have been normal, though I have GCA and PMR. I caught mine soon. Yes, I think it is possible.

[PMRpro Ambassador]

GCA will only show in an examination of the eyes if they look at the retina and where the optic nerve joins the retina. Even then, it will only be apparent if there has been extended poor blood flow to the optic nerve which can change its appearance making it swollen and paler. In some cases of GCA visual loss the loss of blood supply is sudden. It is a bit like the difference between angina and a proper heart attack in some ways. So if there has been long term poor blood flow to the optic nerve it may be seen but not if the development of inflammation and poor blood flow is sudden.

[prunus in reply to PMRpro]

Again I very much appreciate your help. I am having a lot of problems with my eyes at the moment. When I went to the optometrist a fortnight ago he has now added astigmatism to the prescription. Until I had the cataracts operated on I had been quite myopic from being nine years old, never with astigmatism. The readings were -4.5. It is almost 6 years since GCA was diagnosed - CRP 452. (That is correct). I am finding near focusing to read at the end of the day difficult. I don't know which is what nor how to handle it. I originally also had a TIA.

[PMRpro Ambassador in reply to prunus]

Could it be advancing age do you think? I find focussing in the evenings - and especially with artificial light - has become more difficult in the last few months. Your vision was similar to mine - oh for cataracts!!!!!!! I used to cope by moving my specs up and down my nose but it isn't as effective now - perhaps something else is going on. I asked for an eye appointment (no use going to the optician here in Italy, they can't do anything) but the earliest is April!

[Constance13 in reply to PMRpro]

April? Blimey! Can’t you pop back over to Germany and see an Augenarzt? Even privately it wouldn’t cost you a bomb!

[PMRpro Ambassador in reply to Constance13]

Probably not too bad here or in Austria either. OH has suggested private a couple of times but I'm saving it for when it is needed!

[Constance13 in reply to PMRpro]

I’ll send you the cash, then you can have it sooner.😀

[prunus in reply to PMRpro]

Age does come into it - I'm turned eighty. I have an excellent lamp by my chair. One thought I had - prednisolone caused my cataracts could it now have caused the astigmatism? I coped with the cataracts by keep going back to my optometrist but it cost a fortune and finally my head could not cope with the difference in the two readings - that was between the two ops. Go back Thursday have a few more questions lined up - he has a big book of words if he is stuck! I've stopped doing my favourite su doku and my head is easier- could all the eye movement be a problem at this age?

[PMRpro Ambassador in reply to prunus]

alcon.com/news/media-releas...

If you google cataracts and astigmatism there are a load of links about it. Interesting I found.

[piglette in reply to prunus]

Apparently as we get older we do get longer sighted so we are not so good at seeing short distances but can sometimes drive with no glasses after having used them all our lives. I have had an astigmatism in my left eye as long as I can remember, I would not have known except an optician must have mentioned it once, they do not normally say anything. I am not sure what difference it makes to me. My max CRP was 415 you beat me!

[prunus in reply to piglette]

Thanks for the reply. When I originally asked the Consultant what her highest CRP she had had was she said in the nineties. So it is not common up there. I kept being asked where the pain was but just felt awful. I bet you did too.

[piglette in reply to prunus]

Originally before I was diagnosed my CRP was 126 and I was in excruciating agony. When it was 415 I was in hospital having a new hip, I was not too bad but I was on morphine at the time. My orthopaedic surgeon had a bit of a fit though.

[prunus in reply to piglette]

Why did your Surgeon have a bit of a fit? How did you cope with both? I found one bad enough.

[piglette in reply to prunus]

I don’t think he had seen such a high CRP before, he was petrified of infection in the hip, I had to stay in hospital twiddling my fingers.