Neuro-Ophthalmic

Arteritic Anterior Ischaemic Optic Neuropathy (Giant Cell Arteritis)

Also known as: AAION, arteritic AION, arteritic anterior ischaemic optic neuropathy, arteritic ischaemic optic neuropathy, GCA, giant cell arteritis, temporal arteritis, jaw claudication

Filed as: Emergency

Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed

Clinical decision support only

OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.

Overview

Systemic large-vessel vasculitis that threatens sight by infarcting the optic nerve head or occluding a retinal artery. Raises concern in a patient over 50 with new headache, scalp tenderness, jaw claudication, or transient or sudden monocular visual loss. Fellow-eye involvement can follow within days without treatment, so same-day emergency referral with urgent ESR and CRP is required rather than routine outpatient review.

Recognition

Symptoms: what patients report

New headache in a patient over 50.
Scalp tenderness or temporal pain.
Jaw claudication, transient vision loss, or sudden monocular visual loss.
Diplopia can occur and is an emergency association when paired with GCA symptoms or visual symptoms.
A tonic pupil or anisocoria is not typical by itself, but should not reassure when paired with age-risk and GCA symptoms.
Constitutional symptoms such as fatigue, weight loss, or fever.

Signs: what the examination shows

Visual loss may be transient or persistent.
Temporal artery tenderness or reduced pulsation may be present.
Optic neuropathy or retinal ischaemia may coexist.

What OptoGuide™ covers for arteritic anterior ischaemic optic neuropathy (giant cell arteritis)

Pattern reasoning: what this combination of findings points to, and its differentiators
Don't-miss risks and escalation triggers
Management tiers with linked Australian therapeutics
Referral urgency, specialty, and letter drafting

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Sources

Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.

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