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A 72-year-old man had a 2-week history of gradual onset and progressively worsening blurring of right eye vision with retro-orbital pain, but no rhinorrhoea, nasal obstruction or facial pain. He had no fever, infective symptoms, loss of weight or appetite, and no rashes, joint pains, headaches, scalp tenderness or jaw claudication. There was a history of diabetes mellitus, hypertension and hyperlipidaemia. Family history was unremarkable. On examination, there was no eye redness. His right visual acuity was reduced to light perception. There was a grade 3 right relative afferent pupillary defect. Both optic discs were pink with a cup-to-disc ratio of 0.4 and the anterior segment examination was normal. Visual field examination could not be quantified due to his poor vision. The remaining neurological examination was normal. His clinical signs suggested a right retrobulbar …
Contributors YRC was the lead author for this case report, involved in the initial patient care and management, and led the writing of the case report manuscript. CP had contributed to the editing and reviewing of the manuscript. DRS had contributed to the acquisition of imaging results and data.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned: externally reviewed by Luke Bennetto, Bristol UK and Paul Smith, Bristol UK.