A 74-year-old woman presents with sudden painless loss of vision in the right eye. Fundus shows a pale swollen retina with a cherry-red spot at the fovea. She reports recent episodes of jaw claudication and scalp tenderness. Which investigation is the immediate priority to prevent involvement of the other eye?

• A Carotid Doppler ultrasonography
• B Fluorescein angiography
• C Temporal artery biopsy
• D ESR and CRP estimation ✓

Explanation

Jaw claudication and scalp tenderness in an elderly patient with central retinal artery occlusion point strongly to giant cell arteritis, where the fellow eye can be lost within days without systemic corticosteroids. ESR and CRP are rapid screening tests that guide immediate steroid initiation. Temporal artery biopsy confirms the diagnosis but takes time and should not delay treatment, while carotid Doppler addresses atheromatous causes that do not threaten the contralateral eye so urgently.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.