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Surv Ophthalmol. 2017 Oct 10. pii: S0039-6257(17)30240-0. doi: 10.1016/j.survophthal.2017.10.002. [Epub ahead of print]

Tempo(ral) was the heart of the matter.

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Department of Ophthalmology, Neuro-Ophthalmology Service, "De Gironcoli" Hospital, Conegliano, Italy. Electronic address:
Department of Ophthalmology, "Murri" Hospital, Fermo, Italy.
Pathology Unit, Conegliano Hospital, Treviso, Italy.
Baylor College of Medicine, Houston, Texas, USA.


A 71-year-old woman was admitted with fever, headache, and weight loss associated with elevated inflammatory markers. She developed acute bilateral ophthalmoplegia and asymmetrical ptosis, rapidly followed by anterior ischemic optic neuropathy. Although the first temporal artery biopsy was negative, contralateral temporal artery biopsy revealed features consistent with giant cell arteritis. Even while under steroid therapy, she died a few days later from myocardial infarction. Acute bilateral complete ophthalmoplegia is a rare presentation of a limited number of possible diseases. Among these, giant cell arteritis should be suspected in the appropriate clinical scenario.


diplopia; giant cell arteritis; ophthalmoplegia; temporal artery biopsy

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