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Pam comes in to see you for a review. She mentions that she's having pain in her ear when she chews food.
This should alert you to the possibility of giant cell arteritis (GCA) and the need to act swiftly to avoid severe complications. Read more about recognising and managing suspected GCA.
You refer Pam urgently to the local ophthalmology service. While she's waiting to be seen you increase her steroid dose to 50 mg daily (for people without visual symptoms, dose for giant cell arteritis is 40–60 mg daily (minimum 0.75 mg/kg).
You advise her to seek urgent (same-day) medical attention if she develops any problems with her sight, such as: