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Teachable Moment
June 2018

A Case of Preventable Vision Loss

Author Affiliations
  • 1MD Undergraduate Program, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  • 2Postgraduate Medical Education, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
JAMA Intern Med. 2018;178(6):840. doi:10.1001/jamainternmed.2018.0713

A 61-year-old woman presented to her family physician with a 3-week history of jaw pain when chewing, bitemporal headaches, and scalp tenderness. With concern for giant cell arteritis (GCA), she was prescribed oral prednisone, 5 mg daily, for 5 days. However, no further workup was arranged. The headaches mildly improved while she received prednisone but recurred once it was stopped. Two weeks later, she presented to a local emergency department for ongoing symptoms but was discharged without treatment following a normal head computed tomographic (CT) scan result and erythrocyte sedimentation rate (ESR) of 7 mm/hour (normal rate, <21 mm/hour).

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