Is it GCA or side effect of Prednisone

[flygirl65]

Has anyone had blurry vision in one eye, no jaw pain, no headaches and eye exam revealed nothing to worry about in regards to GCA. The blurry vision comes and goes. I am tapering down. Started at 60 mg for 1 day in ER due to PMR then 40mg for 2 days and then 20mg for 2 months. Now down to 13mg reducing 1 mg every 2 weeks under Rhuematolgists advice and the 1 mg per mo from there.

[SheffieldJane]

where you satisfied with the scope of the eye exam? My optician has more equipment than an Opthalmologist I visited and he keeps slides of 3 D images of my eyeball including eye pressure tests, peripheral vision, back of the eye, glaucoma, cataracts . He charges £60.00 for these checks every 6 months and I find them pretty reassuring.

I think Pred alone can cause blurry vision as a side effect, I noticed it on higher doses. I’ve changed my eye glasses prescription 3 times in 7 years.

I found that after 10 mgs I needed a pill cutter to do a slower gentler taper to support my adrenal function. You are right to be alert for GCA symptoms. My non cranial GCA was diagnosed by a specialist scan when I was down to 3 mgs Pred for PMR. It has never involved my temples or eyes, just my armpit.

[flygirl65 in reply to SheffieldJane]

so what is the solution of it doesn’t involve cranial or eyes? Is it upping prednisone again?? My Rheumatologist has me panicked in that he wants me to go to ER if I lose my vision but so far it’s just blurry on one eye.

[flygirl65 in reply to flygirl65]

BTW how are your eyes? Have you had any problems now that you were diagnosed with GCA??

[SheffieldJane in reply to flygirl65]

That worried me too but I knew something was wrong. Just general constitutional symptoms, not PMR symptoms, so luckily I was able to get a scan that confirmed GCA/LVV but not involving the temporal arteries. I was immediately put on 40 mgs and then Tocilizumab shortly afterwards. Without the classic unusual headache, jaw claudication, eye issues, they wouldn’t have found it. I had been vigilant for them for 4 years, fearing loss of sight. I still have to be apparently. Sorry it is difficult, I find it difficult.

[flygirl65 in reply to SheffieldJane]

Thank you that is reassuring. She did all the machines and dismayed the eyes so I feel the exam was very thorough! That is why I wasn’t to worried but I guess the rheumatologist has seen more than I have and he panicked me when I mentioned blurry eye, which of course makes me panick. Having read this blog though it seems quite a common Pred side effect!

Thank you for your response it helps!

[123-go]

Hi. Has a cataract been ruled out? An examination for this would involve the use of eye drops to dilate the pupil.

[flygirl65 in reply to 123-go]

yes no cataracts . Had eyes dialated and nothing abnormal.

[highland-1]

I have blurred vision in both eyes as well a vertical double vision , visited opticians as well as eye hospital both have said everything is fine with eyes and tapering down from 60 mg prednisolone now on 40 mg .

The doctor thinks it could be a neurological problem FND as I have been diagnosed with this condition as well as GCA .

[PMRpro Ambassador]

What was the basis for the claim that the eye exam showed no GCA? It may not have shown SIGNS of GCA but that doesn't mean you don't have GCA. If there is long term reduced blood flow to the optic nerve within the brain then the optic disc may be paler than usual and swollen. But if the GCA is anywhere else it won't do that. Just as the temporal artery biopsy isn't definitive - GCA doesn't affect all arteries equally.

That said - blurry vision can happen due to PMR or pred or both - or other things! Helpful I know ... But one eye showing blurry vision without any other symptoms - including worsening PMR symptoms - isn't an immediate reason to panic and is unlikely to be taken very seriously by the ED.

Have you any signs of dry eyes? Gritty, dry feeling, copious thin tears, tired feeling when reading or using a screen? That can also cause burred vision and it can be worse in one eye than the other.

[flygirl65 in reply to PMRpro]

no other symptoms just blurry in the right eye and it is not constant. Comes and goes. Sometimes I feel like I have a tension headache but I believe that is what it is. I am feeling better after 4 days of tapering. But it seems like every time I drop the prednisone even 1 mg it takes a few days to adjust. I don’t know if this is all part of the process but what I don’t want is to up the dose each time if my body needs this time to adjust.

Again thank you for your knowledge it does help!

[PMRpro Ambassador in reply to flygirl65]

A lot of people need a few days to adjust to the change in dose - part of the reason we counsel small steps and not too often, otherwise you just permanently feel rubbish!

[PMRpro Ambassador in reply to flygirl65]

And forgot to mention - blurriness with dry eyes can vary - improving when you blink for example or have drunk more.

[Crocus123]

I had some blurriness in one eye a couple of months after starting pred, the G,P, dismissed it at the time. It continued with some occasional flashing lights later too. Five months later I woke with a large blurry blob after a night with quite a light show and was packed off to an 'urgent' eye clinic that day. The diagnosis was posterior vitreous detachment. Now six months farther on the blob, a giant floater, has broken up a bit but is still quite intrusive and a light show is an infrequent event, more like one or two cheap rockets not a full display.

[PMRpro Ambassador in reply to Crocus123]

I think that is the sort of thing I'd have taken to the optometrist/optician who CAN examine the back of the eyes, unlike the GP! In the UK there is the MECS option.

primaryeyecare.co.uk/servic...

[Crocus123 in reply to PMRpro]

Yes I tried the minor eye conditions service. They sent me to the eye hospital (St Pauls, Liverpool) when I'd described the symptoms over the phone. I'd have gone when the first symptoms started if I'd known about the MECS at that point.

[Miacaro45]

I think you are tapering much too fast. Slow and steady. It is not a race.