Once the diagnosis of AION is made, in the management of AION, the first, most important step in all patients aged 55 and over is to rule out giant cell arteritis immediately - because that is a prime ophthalmic emergency, since patients with giant cell arteritis are in danger of bilateral total blindness.
Blindness is almost always preventable with aggressive treatment. .
Naturally the question arises as how to differentiate arteritic AION due to giant cell arteritis from non-arteritic AION to prevent this tragedy. This is discussed in detail elsewhere. In our recent study, jaw claudication and neck pain emerged as the symptoms with the highest odds of being associated with giant cell arteritis . Thus, contrary to the popular belief, every patient with giant cell arteritis does not have systemic symptoms . We have found CRP a highly useful test in diagnosing and monitoring the activity of giant cell arteritis.