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To the Editor: In their Rational Clinical Examination article about temporal arteritis, Drs Smetana and Shmerling¹ suggest that a temporal artery biopsy is important but fail to consider the role of the ophthalmologist. A more rational approach would include a complete ophthalmic examination by an ophthalmologist, neuro-ophthalmologist, or retina specialist. The eye findings could point toward the correct diagnosis (and might suggest other reasons to proceed with the contemplated temporal artery biopsy).

Because many patients with temporal arteritis have ocular manifestations,² a complete eye examination is most useful in any patient suspected of having temporal arteritis. When performed in a timely fashion, such an examination, along with evaluation of the erythrocyte sedimentation rate (ESR) and C-reactive protein laboratory tests can allow for a presumptive diagnosis of temporal arteritis. Such a patient can be started on high doses of systemic corticosteroids and a temporal artery biopsy can be scheduled to be . . . [Full Text of this Article]

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Does This Patient Have Temporal Arteritis?
Gerald W. Smetana and Robert H. Shmerling
JAMA. 2002;287(1):92-101.
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