Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects

Mariam Hussain, Ashwini Kini, Bayan Al Othman, Claudia Prospero Ponce, Helen Li, Andrew G. Lee

Research output: Contribution to journalArticlepeer-review


A 67-year-old woman presented with acute loss of vision to no light perception (NLP), a right afferent pupillary defect, and anisocoria with a nonreactive and dilated pupil in the right eye. Fundus examination showed pallid optic disc edema and a central retinal artery occlusion (CRAO) in the right eye. A temporal artery biopsy showed giant cell arteritis (GCA). Orbital involvement in GCA has been reported previously. However the combination of an afferent and efferent pupillary defect, NLP vision, pallid disc edema, and a CRAO in an elderly patient is likely a unique clinical combination that should strongly suggest GCA. Clinicians should be aware of the myriad presentations of GCA, including orbital ischemia.

Original languageEnglish (US)
Pages (from-to)530-532
Number of pages3
JournalJournal of Neuro-Ophthalmology
Issue number4
StatePublished - Dec 1 2020

ASJC Scopus subject areas

  • Medicine(all)


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