Giant cell arteritis (GCA) is a focal, segmental, granulomatous arteritis characterized by disruption of the internal elastic lamina and vascular occlusion in medium to large vessels. Involvement of the ophthalmic artery and its branches typically results in irreversible vision loss from arteritic anterior ischemic optic neuropathy (91%), central retinal artery occlusion (10.5%), cilioretinal artery occlusion (10%), or arteritic posterior ischemic optic neuropathy (4%), either alone or in combinations.1 Prompt, aggressive systemic corticosteroid is the mainstay of treatment to prevent bilateral blindness. A proportion of patients with initial visual impairment also continue to deteriorate despite adequate treatment.2