Doctors of optometry have big role in catching giant cell arteritis before blindness

A new study on giant cell arteritis (GCA) confirms the frontline role doctors of optometry can play in diagnosing the disease.

GCA occurs when the arteries in the head become inflamed. It typically happens to people over age 50 and more often in women. The international study, which involved 433 newly diagnosed patients in 23 countries, was the biggest to date on people suffering with GCA.

"The significance of this study on giant cell arteritis is that often the presenting symptom is anterior ischemic neuropathy, which can lead to blindness," says Dr. Saysha Blazier, O.D., who practices at Savoy Siegel + Desai in Jersey City, New Jersey, and is a member of AOA's Health Promotions Committee.

"As eye-care providers, we hold a key role in the immediate, proper treatment prior to clinical diagnosis so we can attempt to save vision in at least one eye as well as prevent other irreversible systemic sequelae," Dr. Blazier adds.

The study, conducted over a six-month period, was designed to:

• Assess the frequency of GCA-associated blindness.
• Evaluate the possible vascular risk factors.

Researchers say that previous studies had neither established GCA's frequency nor its risk factors, though cardiovascular disease had been previously linked as a risk factor.

"Six months after the diagnosis of GCA, the incidence of complete blindness in at least one eye was 7.9%," study co-author Max Yates, MBBS, of the University of East Anglia in England, told MedPage Today.

Further, the research linked GCA patients to strokes and peripheral vascular disease. Yates shared his results at the annual meeting of the British Society for Rheumatology in Glasgow, Scotland, in late April.

Symptoms include:

• Double vision or vision loss
• Persistent headaches
• Fatigue
• Dizziness

The study "suggests that blindness remains a major clinical problem and highlights the need for urgent referral and treatment," the authors wrote. "The association with prior vascular disease indicates a need for greater vigilance in this group."

Vigilance is where doctors of optometry come in.

"Key is the role of optometrists in the overall health care system, including communication with the rheumatologist, and then moving forward with social workers, occupational therapists and other providers to manage any vision loss, which would affect an individual's quality of life and their activities of daily living," Dr. Blazier adds.

The AOA follows all research closely, including potential treatments for GCA; however, more research is needed regarding influence on visual health.