Cross-department team effort conquers rare inflammatory eye disease

Quan Dong Nguyen, MD, MSc, FARVO, (left) continues to see patient Yolanda Velasco for evaluations every three months.

Three years ago, Yolanda Velasco began noticing difficulty distinguishing words and images on her computer screen. After her retina specialist attended a conference where Quan Dong Nguyen, MD, MSc, FARVO, professor of ophthalmology and director of the Uveitis and Ocular Immunology Service at the Byers Eye Institute at Stanford, was lecturing, he referred Velasco to Nguyen. Nguyen diagnosed Velasco with panuveitis, an uncommon condition of inflammation throughout the eye, which can lead not only to worsening vision, but to total blindness.

After trying first-line medications, Velasco was not seeing improvement in her vision, so Nguyen offered to enroll her in a clinical research program. There they stumbled upon an accidental second discovery: every time she had blood drawn for the clinical trial, her blood kept clotting.

Nguyen recognized there was an underlying disease and directed Velasco to David Iberri, MD, clinical assistant professor of medicine in the division of hematology, who diagnosed her with chronic lymphocytic leukemia (CLL), a type of white blood cell cancer.  

Nguyen and Iberri teamed up to tailor Velasco’s treatment, which has included chemotherapy against the CLL cells, and additional, newer medications infused to block residual cancer cell antibodies from inflaming and damaging the retina. Together, these therapies allowed Velasco to regain some of the vision she’d lost.

"Our ability at Stanford to customize and individualize care for a patient with novel, innovative treatments was critical,” Nguyen said.

With restored vision, Velasco has resumed driving to see her children and grandchildren, which had to pause when her vision was at its worst.

“I have had the best experience with the entire Stanford team,” Velasco said. “While my eye diseases set me back, the care I received at Stanford consistently gave me the strength I needed to move forward.”


Kathryn Sill is a web and communications specialist for the Byers Eye Institute in the Department of Ophthalmology, at Stanford University School of Medicine. Email her at