13th August 2020

A 60-year-old lady presents to the emergency department (ED) with an acute transient loss of vision in the right eye

A 60-year-old lady presents to the emergency department (ED) with an acute transient loss of vision in the right eye. She says it was like a ‘curtain came over my eyes’ and was painless. Her vision returned to normal in 20 mins. You elicit that she has also been experiencing a right temporal headache associated with increased pain on chewing and on brushing her hair over the last week. She also reports pain in her neck and shoulders. On examination, there is marked tenderness of the scalp over the temporal regions, the temporal arteries appear thickened bilaterally and right shoulder movements are restricted. Visual acuity is 20/20 bilaterally, eye movements are preserved and painless. On this occasion you cannot locate the optic disc as the patient is not cooperative and complains of pain in her neck when you attempt examination.  

What is the most likely diagnosis of her ophthalmological presentation?

For the patient above, please select the most appropriate diagnosis. Select ONE option from the list above.