PMR progressing to GCA? Broken vessels in eye

Posted by ldingwall88 @ldingwall88, Sep 27, 2022

Hi-- I was diagnosed with PMR in May. I started at 40mg prednisone and was finally able to go down to 30mg at the beginning of September. The past week I've had an increase in PMR pain and planned to call my dr about it. However, this afternoon I noticed a large blood patch covering most of the outer corner of my right eyeball and now I'm concerned about GCA. I looked up the symptoms but that doesn't seem to be one of them--but as you can imagine, I'm in a bit of a panic and although I called my dr, I had to leave a message. Does anyone have any info about this? I've never had anything like this before and am very concerned.

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I can't really say if the blood patch is/isn't related to your PMR or GCA. However, your starting dose of 40 mg of prednisone is extremely high for PMR. Usually the starting level is 15 mg/day or sometimes 20 mg. Just curious why your doctor more than doubled the normal beginning prednisone dose for a new PMR patient.

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I have GCA. I doubt that what you are experiencing in your eye has to do with GCA. For me, I lost my vision temporarily 3 times because the artery feeding the eye was narrowing.
Do you have any other symptoms of GCA ie. painful scalp, jaw pain, headaches?

I am not a doctor. You might want to see an ophthalmologist and get your eye checked.

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@raven1955

I can't really say if the blood patch is/isn't related to your PMR or GCA. However, your starting dose of 40 mg of prednisone is extremely high for PMR. Usually the starting level is 15 mg/day or sometimes 20 mg. Just curious why your doctor more than doubled the normal beginning prednisone dose for a new PMR patient.

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Hi, yes, I know anything above 20mg is unusual. Unfortunately, 40mg was the only level that calmed down the flare. (Once I hit 40mg, it went away almost like magic.) My dr said that it's unusual to start as such a high dose, but it does happen. Obviously I'm not thrilled to be on prednisone at all, much less so much, but I'm happy to have been able to start tapering and hope I can continue to get down to a low level. The side effects are awful!

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@SusanEllen66

I have GCA. I doubt that what you are experiencing in your eye has to do with GCA. For me, I lost my vision temporarily 3 times because the artery feeding the eye was narrowing.
Do you have any other symptoms of GCA ie. painful scalp, jaw pain, headaches?

I am not a doctor. You might want to see an ophthalmologist and get your eye checked.

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Thanks so much for this, I really appreciate it. I've called the eye dr and they're going to try to work me in today or tomorrow. I don't have any other GCA symptoms *except* for headaches; I have chronic thunderclap headaches (2-3x/week), so I really have no way of knowing if there's a connection, though I kind of doubt it. Thanks again for your post!

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@ldingwall88

Hi, yes, I know anything above 20mg is unusual. Unfortunately, 40mg was the only level that calmed down the flare. (Once I hit 40mg, it went away almost like magic.) My dr said that it's unusual to start as such a high dose, but it does happen. Obviously I'm not thrilled to be on prednisone at all, much less so much, but I'm happy to have been able to start tapering and hope I can continue to get down to a low level. The side effects are awful!

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Okay, thanks for clarifying the starting dose. It just had my curiousity up. But yes what matters is that dose calmed down the flare! None of us are in love with prednisone but thank goodness it's mostly effective against PMR. I'd be a total invalid without it.

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I have PMR. My husband does not. He has had blood vessels break on his eyeball a couple of times a year the last several years. Each time he went to an ophthalmologist and was told that there was no worry. Long story short, his blood vessel breaks were from changes in blood pressure. He is now on blood pressure medicine and has been diagnosed with heart issues,-AFIB and heart failure issues. The broken blood vessel was a signal of serious heart issues.

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@loyal

I have PMR. My husband does not. He has had blood vessels break on his eyeball a couple of times a year the last several years. Each time he went to an ophthalmologist and was told that there was no worry. Long story short, his blood vessel breaks were from changes in blood pressure. He is now on blood pressure medicine and has been diagnosed with heart issues,-AFIB and heart failure issues. The broken blood vessel was a signal of serious heart issues.

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Oh wow, I guess I'd better get it checked out. Thanks so much for the info and best wishes to you both.

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Oh, I hope you don't have that problem. Good luck and let us know how it goes.

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Thanks to everyone who commented and voiced concern. I saw the ophthalmologist today and she said it was nothing to be concerned about, that GCA could be ruled out because I had no other symptoms. Based on @loyal 's comment I put in a call to my GP just to be safe and am waiting to hear back. Fingers crossed it was just a random thing.

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I've had PMR for over 1.5 years and have been on 1 to 2 mg. of Prednisone for months, trying to taper off. During this last attempt to taper off, I started experiencing mild headaches at night behind my eyes. Since I rarely ever have headaches, this concerns me enough to have it evaluated for GCA. I also had some unusual pain last night in my hip joints that seemed to radiate towards my thighs. I haven't had any thigh pains for over a year and my pain, if any, seems confined to my upper arms and occasionally mid back when I try to taper off. BTW, I normally only feel pain when laying down and not when upright for some reason.

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