Publications by authors named "Walter M Jay"

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.

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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.

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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.

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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.

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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.

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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).

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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.

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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.

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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.

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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.

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Headache and the eye.

Curr Opin Ophthalmol

November 2009

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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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