Case Report: High Intraocular Pressure vs Temporal Arteritis, a Diagnostic Challenge

Temporal arteritis is a sight-threatening condition requiring urgent intervention. We present the case of an 81-year-old gentleman with a blind right eye who presented with persistent unilateral temporal pain. Initially treated empirically for temporal arteritis due to systemic symptoms and mildly elevated C-reactive protein, his symptoms persisted. Ophthalmic evaluation revealed a Grade 4 hyphema with significantly elevated intraocular pressure (IOP). Despite initial medical management, recurrent intraocular haemorrhage led to sustained IOP elevation and pain. Given his blind eye, management prioritised comfort, with cyclodiode laser therapy successfully achieving long-term IOP control. This case underscores the importance of considering ocular pathology, even in blind eyes, when systemic symptoms mimic alternative diagnoses. Furthermore, it highlights cyclodiode laser therapy as a valuable intervention for IOP control in elderly patients with limited treatment options.