Alternating Transient Monocular Vision Loss Due to Giant Cell Arteritis

Giant cell arteritis is a systemic granulomatous vasculitis commonly involving the temporal artery and associated with visual deficits. The most common ocular presentation of giant cell arteritis involves anterior ischemic ocular neuropathy with sudden unilateral vision loss. We present a rare case of alternating painless monocular vision loss in an older man who responded clinically to prolonged glucocorticoid therapy, tocilizumab, and intraocular pressure–lowering ophthalmic medications.