DR. ANAND SINGH BRAR

DR.SRIKANTA KUMAR PADHY

Abstract

81-year-old male had sudden painless loss of vision in right eye following an ischemic stroke and hypertensive emergency. He had a central retinal artery occlusion (CRAO) in the left eye 2 weeks earlier. He had dysphagia and jaw claudication with erythrocyte sedimentation rate of 72 mm/hr. An oral examination revealed bilateral anterior ‘tongue gangrene’. Ocular findings were suggestive of ophthalmic artery occlusion in right eye. Due to high suspicion of Giant cell arteritis (GCA), high dose intravenous corticosteroids were initiated along with the temporal artery biopsy. Giant cell arteritis can manifest as CRAO and ophthalmic artery occlusion. This case highlights the importance of identifying lingual necrosis along with the ocular manifestations in GCA, as it is an uncommon manifestation indicative of severe disease with increased mortality risk.