Eyes Giant Cell Arteritis

Overview

Giant cell arteritis (GCA) is a condition where the body's immune system causes inflammation in some blood vessels. It often affects arteries around the temples and scalp. It can also reduce blood flow to the eyes, which can cause sudden vision loss. GCA is also called temporal arteritis. It is not an eye infection, and it needs urgent medical care.

GCA is uncommon, but it is important because it can cause permanent vision loss if not treated quickly. Doctors look for it quickly when older adults have a new severe headache, jaw pain, or vision symptoms.

GCA mostly affects adults over 50. It is more common in women and in people of northern European descent. It is very rare in people under 50 and in children. It is not contagious.

Symptoms

Common symptoms

• New, severe headache, often on one side or around the temples
• Tender scalp, so combing hair or wearing a hat hurts
• Jaw pain or tiredness when chewing or talking
• Tenderness or swelling over the arteries near the temples
• Vision changes: blurring, double vision, a curtain over part of vision, or sudden loss of vision
• Feeling very tired, fever, night sweats, or weight loss
• Pain and stiffness in the shoulders, hips, or neck, often with a related condition called polymyalgia rheumatica

Symptoms in children

• Giant cell arteritis is extremely rare in children. A child with a severe headache, fever, or vision change should still be checked urgently, but GCA is unlikely.

Symptoms in older adults

• Most cases happen after age 50. Symptoms can start quickly and may include a new headache, scalp tenderness, jaw pain, fatigue, fever, weight loss, and vision changes.
• Vision symptoms in an older adult are an emergency, even if other symptoms seem mild.

Causes

Main causes

• GCA happens when the body's immune system mistakenly causes inflammation in the walls of some blood vessels.
• The exact trigger is not known. Genes and environment may play a part.

Risk factors

• Age over 50
• Being female
• Having polymyalgia rheumatica
• Being of northern European descent
• A family history of GCA or polymyalgia rheumatica

When to see a doctor

See a doctor urgently if:

• You have a new severe headache and you are over 50
• You have scalp tenderness or jaw pain when chewing
• You have fever, weight loss, and fatigue with a headache
• You have any new vision change — call emergency services immediately

Book a routine appointment if:

• Follow-up appointments for known GCA
• Side effects from treatment
• Bone health and eye checks
• Return of symptoms after reducing treatment

Diagnosis

Doctors ask about your symptoms, examine you, and check blood tests for inflammation. They may use an ultrasound of the arteries near the temples or take a tiny sample of the artery, called a biopsy. Treatment may start before all tests are finished because protecting vision is urgent.

Tests that may be done

• Blood tests for inflammation, often called ESR and CRP
• Ultrasound scan of the arteries near the temples
• Temporal artery biopsy: a small sample of the artery is checked under a microscope
• Sometimes other imaging scans, such as MRI or PET, if needed

What to expect at your appointment

You may be seen the same day by a specialist. Some tests are quick, but biopsy results can take a few days. Your doctor may start treatment before results are back. Ask your healthcare provider what each test is for.

Treatment

GCA is treated urgently to protect your eyesight and calm the inflammation. You will usually be referred to a specialist and followed closely.

Self-care at home

• Take your medicines exactly as prescribed and do not stop them without advice.
• Keep a note of new or worsening symptoms, especially vision changes.
• Attend all follow-up appointments, including eye checks and blood pressure checks.
• Ask your doctor whether you need bone health checks or supplements.
• Rest when you feel tired, and ask for help with daily tasks during flare-ups.

Medical treatments

Treatment usually starts the same day with strong anti-inflammatory medicines called corticosteroids, often just called steroids. These are different from the steroids some athletes use. The dose is decided by your doctor and slowly reduced over months. You may also need medicines to protect your bones and to manage side effects. Regular blood tests and check-ups help your doctor adjust treatment safely.

When is surgery considered?

Surgery is not usually part of treating GCA. Rarely, surgery may be needed for a blood vessel problem, such as a weakened or narrowed artery.

Living with this condition

GCA can make you feel very tired and unwell at first. Most people need time off work or extra rest. Treatment often improves symptoms within days, but the medicine is usually needed for many months. You will have regular check-ups to watch for side effects and relapse.

Lifestyle tips

• Pace yourself and rest when needed.
• Ask family or friends for help during flare-ups.
• Keep gently active as you feel able.
• Avoid smoking and get support to quit.
• Check with your doctor before starting new exercise or supplements.

Diet and exercise

Eat regular balanced meals and stay hydrated. Gentle activity, such as walking, can help you feel better when your symptoms are controlled. Ask your doctor before starting intense exercise.

Mental health and emotional wellbeing

It can be scary to have a condition that threatens your sight. Feeling anxious or low is common. Talk to your doctor if these feelings last or affect daily life. If you feel in crisis, contact your local emergency services or a crisis line in your country.

Prevention

There is no proven way to prevent GCA. The best protection is to know the warning signs and get same-day medical advice if you are over 50 with a new severe headache, jaw pain, or vision changes.

Complications

If left untreated

• Permanent vision loss, which may happen suddenly
• Stroke
• Damage to large blood vessels, including a weakened or bulging aorta
• Narrowing of arteries that can affect the arms or legs

Long-term outlook

With quick treatment, many people avoid serious eye damage and feel much better within days. Some vision loss that has already happened may be permanent, but treatment can protect the other eye and lower the risk of other problems. Relapses can happen, so regular follow-up is important. Most people can return to normal activities over time.

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