Publications by authors named "Walter Jay"

43 Publications

Varicella Zoster Virus in Giant Cell Arteritis: A Review of Current Medical Literature.

Neuroophthalmology 2019 Jun 2;43(3):159-170. Epub 2019 Jul 2.

Department of Ophthalmology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, USA.

In recent years, the search for the cause of giant cell arteritis (GCA) has led investigators to look to varicella zoster virus (VZV) as the answer. In some ways, the nature of VZV infection makes it an attractive explanation for the pathology observed in GCA. However, studies to date yield a level of inconsistency that still leaves uncertainty as to whether VZV directly causes GCA, and positive findings have not been successfully reproduced.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/01658107.2019.1604763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620003PMC
June 2019

and EUNOS are reunited.

Neuroophthalmology 2018 Feb 9;42(1). Epub 2018 Jan 9.

President of EUNOS.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/01658107.2017.1415076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812670PMC
February 2018

Current Perspectives of Bioptic Driving in Low Vision.

Neuroophthalmology 2016 Apr 25;40(2):53-58. Epub 2016 Feb 25.

Department of Ophthalmology, Loyola University Chicago , Chicago, Illinois, USA.

In this review, the authors discuss the current perspectives of spectacle-mounted telescopes (bioptics) used for driving among patients with vision impairments. The history, design, driving laws surrounding bioptic use, and developing programs in The Netherlands and Canada are discussed. Patients who have certain visual requirements and stable disease status may be eligible candidates to consider using a bioptic aid for driving. Given the high prevalence of depression among visually impaired patients, low vision specialists can work with neuro-ophthalmologists to maximise the independence and visual function of patients who have permanent vision impairments but capable of maintaining driving privileges.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2015.1134585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123033PMC
April 2016

GPS Usage in a Population of Low-Vision Drivers.

Semin Ophthalmol 2017 19;32(4):438-442. Epub 2016 Apr 19.

e Spectrios Institute for Low Vision , Wheaton , IL , USA.

Purpose: We surveyed bioptic and non-bioptic low-vision drivers in Illinois, USA, to determine their usage of global positioning system (GPS) devices.

Methods: Low-vision patients completed an IRB-approved phone survey regarding driving demographics and usage of GPS while driving. Participants were required to be active drivers with an Illinois driver's license, and met one of the following criteria: best-corrected visual acuity (BCVA) less than or equal to 20/40, central or significant peripheral visual field defects, or a combination of both.

Results: Of 27 low-vision drivers, 10 (37%) used GPS while driving. The average age for GPS users was 54.3 and for non-users was 77.6. All 10 drivers who used GPS while driving reported increased comfort or safety level.

Conclusions: Since non-GPS users were significantly older than GPS users, it is likely that older participants would benefit from GPS technology training from their low-vision eye care professionals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/08820538.2015.1118137DOI Listing
October 2017

Usage of Accessibility Options for the iPhone and iPad in a Visually Impaired Population.

Semin Ophthalmol 2017 8;32(2):163-171. Epub 2015 Jul 8.

d Department of Ophthalmology , Loyola University Chicago , Chicago , IL , USA.

Purpose: The iPad and iPhone have a number of low-vision accessibility features including Siri Voice Assistant, Large Text, Zoom Magnification, Invert Colors, Voice Over, and Speech Selection. We studied their usage within a low-vision population.

Methods: Patients were recruited to participate in an IRB-approved survey regarding their usage of the iPad and/or iPhone. Participants met one of the following criteria: best corrected visual acuity (BCVA) of 20/60 or worse, or significant peripheral visual field defects.

Results: Thirty-three low-vision patients agreed to participate (mean age 54.3 years). There were 18 different diagnoses represented and the average visual acuity of respondents was 20/119 in the right eye and 20/133 in the left eye. The most commonly used vision accessibility features were Zoom Magnification and Large Text.

Conclusions: Although many patients are using the low-vision accessibility features, few are receiving training or recommendations from their eye care specialist.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/08820538.2015.1045151DOI Listing
March 2017

Rituximab in the Treatment of Thyroid Eye Disease: A Review.

Neuroophthalmology 2015 Jun 17;39(3):109-115. Epub 2015 Jun 17.

Department of Ophthalmology, Loyola University Chicago, Stritch School of Medicine Maywood, Illinois USA.

Graves disease is an autoimmune thyroid disease classically characterised by a clinical triad consisting of hyperthyroidism, diffuse goitre, and thyroid eye disease. Thyroid eye disease is an immunologically mediated condition in which humoral immunity is thought to play a central role. Thyroid eye disease is traditionally treated with high-dose glucocorticosteroids and surgical orbital decompression. However, responses are inadequate and alternative treatment options are needed. Rituximab, an anti-CD20 monoclonal antibody, shows promise as a novel therapeutic option for thyroid eye disease. There are 43 cases of thyroid eye disease treated with rituximab in the medical literature, and larger studies are warranted to determine the long-term effectiveness of rituximab. Rituximab may represent an attractive new treatment option for thyroid eye disease, especially in the case of disease that is refractory to current treatment strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2015.1039140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123122PMC
June 2015

Biologic Therapy for the Treatment of Giant Cell Arteritis.

Neuroophthalmology 2014 2;38(3):107-112. Epub 2014 Apr 2.

Department of Ophthalmology, Loyola University Chicago, Stritch School of Medicine Maywood, Illinois USA.

Giant cell arteritis (GCA), a vasculitis of the medium and large arteries, is traditionally managed with glucocorticoids. However, the side effects of chronic glucocorticoid use and the occurrence of refractory cases warrant the consideration of steroid-sparing agents, including biologic agents. Interleukin-6 (IL-6) inhibition shows the most promise as biologic therapy for refractory cases of GCA, but data to support the use of other existing biologic agents are currently lacking. A better understanding of the pathogenesis of GCA as well as clinical trials investigating both existing and emerging biologic agents is needed to expand therapeutic options for the treatment of GCA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2014.883635DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123077PMC
April 2014

Tablet and Smartphone Accessibility Features in the Low Vision Rehabilitation.

Neuroophthalmology 2014 11;38(2):53-59. Epub 2014 Mar 11.

Department of Ophthalmology, Loyola University Medical Center Maywood, Illinois USA.

Tablet and smartphone use is rapidly increasing in developed countries. With this upsurge in popularity, the devices themselves are becoming more user-friendly for all consumers, including the visually impaired. Traditionally, visually impaired patients have received optical rehabilitation in the forms of microscopes, stand magnifiers, handheld magnifiers, telemicroscopes, and electronic magnification such as closed circuit televisions (CCTVs). In addition to the optical and financial limitations of traditional devices, patients do not always view them as being socially acceptable. For this reason, devices are often underutilised by patients due to lack of use in public forums or when among peers. By incorporating smartphones and tablets into a patient's low vision rehabilitation, in addition to traditional devices, one provides versatile and mainstream options, which may also be less expensive. This article explains exactly what the accessibility features of tablets and smartphones are for the blind and visually impaired, how to access them, and provides an introduction on usage of the features.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2013.874448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123149PMC
March 2014

Horner Syndrome in a Case of Neuromyelitis Optica.

Neuroophthalmology 2014 7;38(2):78-81. Epub 2014 Feb 7.

Department of Neurology.

A 58-year-old right-handed woman presented with neck pain and right hemibody decreased pain and temperature sensation. Over the next 3 days, she developed left ptosis and miosis. The Horner syndrome was confirmed with 0.5% apraclonidine and neuromyelitis optica immunoglobulin G antibody titres were positive. Magnetic resonance imaging of the cervical spine showed a longitudinally extensive intramedullary expansile lesion more prominent on the left, with post-contrast enhancement extending from C2 to C5, consistent with neuromyelitis optica. This patient was diagnosed with neuromyelitis optica with an associated left Horner syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2013.856027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122924PMC
February 2014

Primary Osteosarcoma of the Skull Base in a Pregnant Patient.

Neuroophthalmology 2013 29;37(1):38-40. Epub 2013 Jan 29.

Department of Ophthalmology.

An 18-year-old female who was 14 weeks pregnant first noted vision loss in her left eye six days prior to admission. Ophthalmologic examination revealed 20/20 vision in the right eye and count fingers vision in the left eye. A marked relative afferent pupillary defect was present in the left eye. Ophthalmoscopic examination revealed a trace optic nerve pallor temporally in the left eye without associated disc oedema or haemorrhage. Magnetic resonance imaging of the brain demonstrated a heterogeneous mass of the left sphenoid sinus extending superiorly causing compression of the intracranial portion of the left optic nerve, and laterally into the left cavernous sinus. The patient underwent transphenoidal resection of the tumour whose histologic morphology revealed a grade 2 osteosarcoma. Following resection, vision returned to 20/20 in the left eye. The patient has been treated with chemotherapy with close monitoring of her pregnancy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2012.753914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289272PMC
January 2013

Atypical Chronic Headache and Recurrent Facial Ecchymosis: A Case Report.

Neuroophthalmology 2011 20;35(2):76-77. Epub 2011 Mar 20.

Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, USA.

We present the case of a 57-year-old woman with chronic paroxysmal headache and recurrent facial ecchymosis. The headaches are chronic, unilateral, sharp, electric shock-like, of short duration, without nausea nor vomiting, ptosis, miosis, conjunctival injection nor tearing. The facial ecchymoses have been mainly located in the periorbital and epicanthal areas. General, neurological and ophthalmological examinations were unremarkable. Work-up was unremarkable, including negative skin biopsy. The headache was difficult to include in any particular category given the atypical features, but the characteristics were suggestive of a variant of trigeminal autonomic cephalalgia with lack of responsiveness to indomethacin. We discuss the possible pathogenetic mechanism of the occurrence of facial ecchymosis in primary headache disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/01658107.2011.558666DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104771PMC
March 2011

Resolution of paroxysmal hemicrania after resection of intracranial meningioma.

Semin Ophthalmol 2010 Jan-Mar;25(1-2):34-5

Loyola University, Chicago, IL, USA.

Paroxysmal hemicrania is a trigeminal autonomic cephalalgia first described in 1976, characterized by episodic attacks of excruciating unilateral periorbital and temporal stabbing, pulsatile, craw-like, or boring headaches lasting 2 - 30 minutes, accompanied by autonomic features, and alleviated by indomethacin. Paroxysmal hemicrania is divided into an episodic or chronic form, depending on the duration and frequency of the attacks. We describe a case of paroxysmal hemicrania in a patient with a contralateral anterior clinoid meningioma, which resolved after tumor resection. Most cases of autonomic cephalgias are primary headaches and not caused by underlying intracranial structural lesions. Based on our patient and a literature review of secondary causes of trigeminal autonomic cephalalgias, we recommend that all patients with trigeminal autonomic cephalalgias including paroxysmal hemicrania undergo neuroimaging studies. The preferred neuro-radiologic procedure should be a cranial MRI to exclude underlying structural intracranial lesions, particularly in the sellar and parasellar regions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/08820531003635505DOI Listing
July 2010

Headache and the eye.

Curr Opin Ophthalmol 2009 Nov;20(6):520-4

Department of Neurology, Loyola University Medical Center, Maywood, Illinois 60153, USA.

Purpose Of Review: Visual disturbances and ocular symptoms are common manifestations of two primary headache disorders, migraine and trigeminal autonomic cephalalgias, and many secondary headache disorders.

Recent Findings: Structural lesions have been described with trigeminal autonomic cephalalgias. A systematic diagnostic evaluation including neuroimaging with assessment of intracranial and cervical vasculature, and the sellar and paranasal regions is recommended in every patient presenting with symptoms indicative of trigeminal autonomic cephalalgias for the first time.

Summary: Ophthalmologists are often the first physicians to evaluate patients presenting with headaches and ocular pain or visual symptoms. Knowledge of primary and secondary headache disorders, a detailed history, and a thorough clinical examination are prerequisites for accurate diagnosis and appropriate management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICU.0b013e328331270dDOI Listing
November 2009

Ocular toxicity of hydroxychloroquine.

Semin Ophthalmol 2008 May-Jun;23(3):201-9

Loyola University Medical Center, Maywood, IL 60153, USA.

This review summarizes the current literature regarding the ocular complications of hydroxychloroquine. Hydroxychloroquine has been used since the 1950s for the treatment of various rheumatic and dermatologic diseases. Hydroxychloroquine can cause ocular toxicity, with the most serious being an irreversible retinopathy. At the present time, no "gold standard" exists for identification of the ocular toxicity prior to its development. This has led to controversy regarding the recommendations for ophthalmologic examinations for screening patients on hydroxychloroquine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802049962DOI Listing
July 2008

Neuromyelitis optica (NMO) antibody positivity in patients with transverse myelitis and no visual manifestations.

Semin Ophthalmol 2008 May-Jun;23(3):191-200

Loyola University Medical Center, Maywood, IL 60153, USA.

Background And Purpose: To describe a subgroup of patients with IgG antibody to Aquaporin 4 Protein (AQP4) specific to neuromyelitis optica (NMO), who did not have clinical manifestations of optic nerve involvement at the time of diagnosis.

Methods: Assessment of five patients (four African Americans and one Latino) with myelitis, who were NMO IgG antibody positive, who had no detected optic nerve involvement, over a span of one to eighteen years.

Results: Cerebrospinal fluid (CSF) studies showed lymphocytic pleocytosis, elevated interleukin (IL6), oligoclonal bands (OCB), myelin basic protein (MBP), and elevated albumin and IgG index. Serology showed an association with antinuclear antibody (ANA) positivity and antithyroid peroxidase (TPO) antibody. Our patients responded well to acute treatment with intravenous corticosteroids and long-term treatment with oral prednisone and azathioprine.

Conclusions: The aquaporin protein autoimmune disease previously identified as neuromyelitis optica (NMO) may more correctly be identified as neuromyelitis (NM), and future diagnostic criteria should take into account the population of patients with antibody to aquaporin 4 protein, without clinically evident optic nerve pathology. Future research may indicate that the entity of NMO is a subcategory of the NM population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802049921DOI Listing
July 2008

Magnetic resonance imaging of the orbit.

Semin Ophthalmol 2008 May-Jun;23(3):179-89

Loyola University Medical Center, Maywood, IL 60153, USA.

Magnetic resonance imaging (MRI) employs the nuclear resonance phenomenon to produce images of living tissues. Unlike computed tomography (CT), which relies solely on differences in the propensity of tissues to absorb X-rays to produce various contrasts, MRI offers a wide variety of pulse sequences, each of which exploits differences in the magnetic properties of protons in living tissue to produce contrast resolution. When optimal protocols are used, MRI contrast resolution in the orbital soft tissues is superior to that provided by any other imaging modality. Other advantages of MRI over CT include the ability to select the plane of imaging, and improved safety due to the lack of ionizing radiation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802028677DOI Listing
July 2008

Neuro-ophthalmologic manifestations of primary headache disorders.

Semin Ophthalmol 2008 May-Jun;23(3):169-77

Loyola University Medical Center, Maywood, IL 60153, USA.

Headaches are the most common disorders of the central nervous system affecting 46% of the adult population worldwide. Headaches may be lifelong illnesses, often associated with substantial disability for the individual and the population as a whole. The International Classification of Headache Disorders (ICHD-II) codifies headache disorders into fourteen categories, predominantly primary headaches and secondary headache disorders. Primary headache disorders, mainly migraine and trigeminal autonomic cephalgias (TACs), are frequently associated with neuro-ophthalmologic manifestations. Ophthalmologists are often the first physicians to be involved in the deciphering of headache-related visual disturbances. This article reviews two major primary headache disorders, migraine and trigeminal autonomic cephalgias, and discusses their neuro-ophthalmic complications, clinical presentation, and treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802012937DOI Listing
July 2008

Laparoscopic-assisted lumboperitoneal shunt placement for idiopathic intracranial hypertension.

Semin Ophthalmol 2008 May-Jun;23(3):151-5

Loyola University Medical Center, Maywood, IL 60153, USA.

Lumboperitoneal (LP) shunting is considered an effective method of cerebrospinal fluid (CSF) diversion in patients with idiopathic intracranial hypertension (IIH). Confirmation of flow out of the distal portion of the catheter once in its final position can be difficult, especially in obese individuals. A new technique to improve placement of the peritoneal catheter involves laparoscopic catheter insertion. We performed laparoscopic-assisted LP shunt placement for IIH on four patients. Improvement in preoperative IIH symptomatology was noted in all patients. No laparoscopic-procedure-related complications were noted. No problems were noted in shunt functioning and none of the shunts have required revision surgery at last follow-up. LP shunt related complications were noted in two of the four patients. Complications included bilateral lower extremity lumbar radiculopathy in one patient that resolved with a short course of gabapentin, spinal headache in one patient that resolved with bed rest and fluids, and development of a small intracranial subdural hygroma without mass effect in one patient that is asymptomatic and being followed without clinical consequence. Laparoscopic insertion of the abdominal catheter is safe and effective and does not appear to independently cause an increased risk of complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802007333DOI Listing
July 2008

Seminars in Ophthalmology volume 23-issue 3-Neuro-ophthalmology. Introduction.

Authors:
Walter M Jay

Semin Ophthalmol 2008 May-Jun;23(3):139-40

Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530802077419DOI Listing
July 2008

Vision rehabilitation and Charles Bonnet Syndrome.

Semin Ophthalmol 2008 Mar-Apr;23(2):121-6

Illinois College of Optometry, Chicago, IL 60616, USA.

Purpose: To evaluate the prevalence of visual hallucinations in Charles Bonnet Syndrome (CBS) among patients at a Low Vision Clinic. To determine whether Low Vision Rehabilitation (LVR) intervention results in a decrease of these visual hallucinations.

Methods: We surveyed 50 consecutive new patients in a low vision clinic to determine whether they had experienced visual hallucinations consistent with CBS. All patients were: questioned about the presence of visual hallucinations; given an educational handout that described CBS and reassured them of the benign nature of these hallucinations; and administered Folstein's Mini Mental Status Examination (MMSE). During their low vision examination, all patients received low vision aids to improve their visual function. At follow-up patients who had symptoms of CBS were administered a second survey to evaluate whether they had experienced any change in the frequency of their visual hallucinations.

Results: Of the 50 patients surveyed, 12 of 50 (24%) had visual hallucinations typical of CBS. 6 of these 12 patients (50%) had daily recurring hallucinations. At mean follow-up of 34.9 +/-30 days, a second survey was administered to 11 of the 12 patients diagnosed with CBS. One patient was lost to follow-up. Three of the 11 patients (27.3%) experienced a decrease in the frequency of their hallucinations by 43.33% +/-30.55%. Eight of 11 patients (72.7%) did not note a change in their symptoms.

Conclusions: It is important to include direct questions regarding visual hallucinations in the case history of a low vision examination. LVR may decrease the frequency of CBS hallucinations in some patients. Rehabilitation strategies should include low vision devices that allow for improved visual function and patient education to provide needed reassurance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530801888170DOI Listing
May 2008

Inherited thrombophilia and the eye.

Semin Ophthalmol 2008 Mar-Apr;23(2):111-9

Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA.

Inherited thrombophilic disorders are a well-recognized risk factor for systemic thromboembolism. These disorders include deficiencies of anticoagulant proteins such as protein C, protein S, and antithrombin III, abnormalities of factor V and prothrombin resulting from genetic mutations, and hyperhomocysteinemia. Except for hyperhomocysteinemia, which has been associated with both venous and arterial thrombosis, the other heritable disorders primarily cause venous thromboembolism. We have reviewed the association between heritable thrombophilia and the development of thrombosis in the eye. The available literature consists of case-control studies and case reports. Preliminary data suggest a relationship between thrombotic disorders of the eye and the inherited hypercoagulable states. Some reports show a risk of thrombosis with the presence of factor V Leiden and hyperhomocysteinemia but these associations frequently disappear upon multivariate analysis. It is possible that inherited thrombophilia plays a supportive role to well-established risk factors such as hypertension and diabetes. Larger, well-designed studies will be necessary to clearly define the role of inherited thrombophilia in the development of thrombotic disorders of the eye.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530801888154DOI Listing
May 2008

Giant cell arteritis.

Semin Ophthalmol 2008 Mar-Apr;23(2):99-110

Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA.

This review summarizes the diagnosis, clinical manifestations and management of giant cell arteritis. Giant cell arteritis is an immune-mediated vasculitis of medium to large sized arteries that affects individuals older than the age of 50. Patients typically present with signs of vascular insufficiency of the extracranial arteries of the head and systemic inflammation. Temporal artery biopsy remains the hallmark of diagnosis. Specific treatment regimens must be tailored to each individual, but steroids remain the backbone of therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530801888097DOI Listing
May 2008

Interventional neuroradiology for the ophthalmologist.

Semin Ophthalmol 2008 Mar-Apr;23(2):83-90

Department of Radiology, Loyola University Medical Center, Maywood, IL 60153, USA.

The past two decades have witnessed major advances in diagnosing vascular conditions that affect blood supply and hemorrhagic risk to the brain and the eye. Technological improvements have resulted in the ability to better radiologically image the cerebrovascular system and to deliver pharmacological and embolic agents that have high specificity. Neuroradiological interventional therapy has become the preferred option in managing many conditions that were previously treated by standard neurosurgical procedures. Some of these conditions were considered either inoperable or treatable only with unacceptable neurosurgical risks. This article reviews the current state of the neuroradiological interventional management in conditions that may be encountered in ophthalmological practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530801888055DOI Listing
May 2008

Seminars in Ophthalmology, Volume 23-Issue 2, Neuro-Ophthalmology. Introduction.

Authors:
Walter M Jay

Semin Ophthalmol 2008 Mar-Apr;23(2):81-2

Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530801952380DOI Listing
May 2008

Stroke and driving.

Top Stroke Rehabil 2008 Jan-Feb;15(1):37-41

Illinois College of Optometry, Chicago, Illinois , USA

A major contributor to poststroke patients' independence is their ability to drive. Most poststroke patients desire to drive to maintain autonomy, an active lifestyle, and social contacts. No uniform method exists to evaluate poststroke patients' driving ability. Evaluation methods usually focus on vision, cognition, and motor function. A minimum level of visual acuity is required in every state, but there are significant variations between states. Most states require a visual acuity of 20/40 to 20/70 in at least one eye to obtain a valid driver license. Usually, a patient who has only one functional eye may drive a private vehicle but not a commercial vehicle. A stroke often results in a homonymous visual field defect. The larger the homonymous visual field defect, the more likely it is that the patient will lose his/her driver's license. Many stroke patients are unaware of the field loss that has occurred. A driver rehabilitation specialist is usually an occupational therapist who has specialized in driver evaluation and assessment. Doctors and state agencies refer to a driver rehabilitation specialist patients who do not qualify legally to drive, require new devices to drive, or have a change in their medical history that puts them at risk for an accident.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1310/tsr1501-37DOI Listing
March 2008

Stroke and visual rehabilitation.

Top Stroke Rehabil 2008 Jan-Feb;15(1):27-36

Illinois College of Optometry, Chicago, Illinois, USA

Many patients will experience some type of visual dysfunction following a stroke. The visual changes associated with stroke can be categorized as sensory (visual acuity and visual field), motor (extraocular muscle motility), and perceptual. These disturbances affect the patient's quality of life and can impede overall rehabilitation. Many of these impairments can be addressed by simple yet effective techniques. As a result, vision rehabilitation specialists are becoming an important part of the multidisciplinary stroke rehabilitation team.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1310/tsr1501-27DOI Listing
March 2008

Intravitreal ranibizumab and bevacizumab: a review of risk.

Semin Ophthalmol 2007 Jul-Sep;22(3):201-4

Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, USA.

Ranibizumab (Lucentis), a recombinant monoclonal antibody, blocks all active forms of vascular endothelial growth factor A and was the first treatment for age-related macular degeneration shown to improve visual acuity in a substantial percentage of patients rather than slowing visual loss. Bevacizumab (Avastin) has a similar action, is related to the ranibizumab compound with respect to its structure, but has not been approved by the FDA for intravitreal use and therefore must be utilized only in an off-label setting. While ranibizumab was approved by the FDA at a dose of 0.5 mg per intravitreal injection, the manufacturer recently issued a letter to physicians warning of the increased risk of stroke at the FDA-approved dose as compared to a lower studied dose of 0.3 mg. An interim analysis of the ongoing SAILOR study revealed a 1.2% risk of stroke in the 0.5 mg arm versus 0.3% in the 0.3 mg arm (p = 0.02). It is unclear whether the trend toward a higher risk of stroke in patients receiving 0.5 mg dose of ranibizumab would persist in the final analysis, but details such as causality, topography, and severity of stroke in the SAILOR study should also be delineated. The risks of intraocular use of bevacizumab remain largely unknown at this time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530701543024DOI Listing
November 2007

Spasm of the near reflex in a patient with multiple sclerosis.

Semin Ophthalmol 2007 Jan-Mar;22(1):29-31

Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA.

A 33-year-old woman with a history of relapsing-remitting multiple sclerosis presented with complaints of episodic horizontal diplopia and blurred vision over the past two months. The patient gave a past history of similar episodes of diplopia that had occurred with previous clinical relapses of her multiple sclerosis. On eye movement examination, the patient exhibited intermittent spasms of convergence coupled with miosis. On upward gaze, the convergence and miosis became more marked. An auto-refraction revealed variable measurements in both eyes, consistent with accommodative spasms. A cycloplegic auto-refraction revealed significantly lower myopia present in both eyes than the initial pre-cycloplegic auto-refraction with minimal variability in readings. Symptomatic relief was achieved by cycloplegia and spectacle correction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530601182535DOI Listing
May 2007

Traumatic bitemporal hemianopia.

Semin Ophthalmol 2007 Jan-Mar;22(1):3-7

Loyola University Medical Center, Maywood, IL 60153, USA.

A 45-year-old male pedestrian was struck by a motor vehicle moving at high speed. Upon initial assessment, the patient scored a 3T on the Glasgow Coma Scale. The patient suffered multiple facial and sinus fractures, a right orbital wall fracture, and a depressed open frontal skull fracture with visible brain parenchyma. Due to the nature of the brain injury, the patient was taken to the operating room emergently for a right frontal craniectomy. The patient required prolonged hospitalization followed by transfer to a rehabilitation facility. Six weeks after the accident, the patient underwent an extensive neuro-ophthalmologic evaluation. At that time, visual acuity was 20/200 in both eyes. On visual field testing, a bitemporal hemianopia was noted. Ophthalmoscopic examination revealed bilateral temporal disc pallor, right greater than left. Neuroimaging demonstrated damage to the optic chiasm. Although rare, head trauma may cause a bitemporal hemianopia secondary to optic chiasmal injury.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530601182543DOI Listing
May 2007

Neuro-ophthalmologic manifestations of epilepsy.

Semin Ophthalmol 2006 Oct-Dec;21(4):255-61

Department of Neurology, Loyola University Medical Center, Maywood, Illinois 60153, USA.

This review summarizes the major neuro-ophthalmologic manifestations of epilepsy. Positive or negative visual manifestations such as hallucinations or visual loss may be seen. There is considerable overlap of the visual manifestations with migrainous aura and transient ischemic attack (TIA), making a detailed history important for accurate diagnosis. Oculomotor manifestations, such as tonic eye deviation, are often recognized to have localizing value. Nystagmus or repetitive blinking may be present and offer clues in clinically subtle seizures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08820530601006742DOI Listing
March 2007
-->