Bio

Clinical Focus


  • Ocular inflammatory disease, uveitis and cornea
  • Ophthalmology

Academic Appointments


Administrative Appointments


  • Chief, Uveitis Service, Department of Ophthalmology Stanford University (1998 - 2014)
  • Clinical Professor, University of California, San Francisco (2004 - 2014)
  • Director, Uveitis and Ocular Immunology, F.I. Proctor Foundation, University of California, San Francisco (1994 - 2008)
  • Associate Director, Clinical Affairs, F.I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco (2005 - 2009)
  • Chief of Ophthalmology, Kaiser Permanente Medical Center, Redwood City, CA (1979 - 1998)
  • Cataract Management Guideline Panel, U.S. Dept Health and Human Services (1990 - 1993)
  • Vice President, Ophthalmic Practice, California Academy of Ophthalmology (1996 - 2002)

Honors & Awards


  • Senior Achievement Award, American Academy of Ophthalmology (2005)
  • Honor Award, American Academy of Ophthalmology (1988)
  • America's Top Doctor, Consumers' Research Council of America (2003 - 2014)
  • Best Doctors in America, Pacific Edition (1997 - 2014)

Professional Education


  • Fellowship:University Of Iowa Hospitals and Clinics (06/74) IA
  • Residency:University Of Iowa Hospitals and Clinics (06/73) IA
  • Internship:University Of Iowa Hospitals and Clinics (06/70) IA
  • Fellowship:UCSF Graduate Division - Fellowships (06/77) CA
  • Medical Education:George Washington University Medical School (6/1/69) DC
  • Board Certification: Ophthalmology, American Board of Ophthalmology (1975)
  • M.S., University of Iowa, Ophthalmology (1973)
  • M.D., George Washington University, Medicine (1969)
  • M.A., University of Minnesota, Clinical Psychology (1965)
  • B.A., University of Oregon, Experimental Psychology (1963)

Research & Scholarship

Current Research and Scholarly Interests


Investigation into immunomodulatory treatment of ocular inflammatory diseases.
Investigator, NIH sponsored Multi-centered Uveitis Steroid Treatment Trial.
Epidemiology of uveitis and ocular inflammatory diseases.

Publications

Journal Articles


  • Incidence and prevalence of episcleritis and scleritis in northern california. Cornea Honik, G., Wong, I. G., Gritz, D. C. 2013; 32 (12): 1562-1566

    Abstract

    To evaluate the incidence and prevalence of episcleritis and scleritis in a large well-defined population in Northern California.Secondary analysis was performed on data from the Northern California Epidemiology of Uveitis Study. The patient database of a large regional health maintenance organization was searched for all patients who potentially experienced ocular inflammatory disease during the 12-month study period. Medical records were reviewed for all potential patients to confirm ocular inflammatory disease and specific diagnosis, establish the time of onset, and collect additional data. Age- and sex-stratified quarterly study population data were used to calculate incidence rates and prevalence ratios.After reviewing 2011 possible cases, 297 new-onset cases of episcleritis, 39 prior-onset cases of episcleritis, 25 new-onset cases of scleritis, and 8 prior-onset cases of scleritis were confirmed. For episcleritis, the overall incidence was 41.0 per 100,000 person-years and an annual prevalence ratio of 52.6 per 100,000. The overall incidence of scleritis was 3.4 per 100,000 person-years and an annual prevalence ratio of 5.2 per 100,000 persons. For both episcleritis and scleritis, there was a statistically significant increase in eye disease in older patients (P = 0.05 and <0.001, respectively) and for women in comparison with men (P = 0.001 and <0.001, respectively). Patients with scleritis were older than those with episcleritis (P = 0.017).This study found that patients with scleritis were older than those with episcleritis and that women had higher rates of both episcleritis and scleritis compared with what men had.

    View details for DOI 10.1097/ICO.0b013e3182a407c3

    View details for PubMedID 24145628

  • Epidemiology of Ulcerative Keratitis in Northern California ARCHIVES OF OPHTHALMOLOGY Jeng, B. H., Gritz, D. C., Kumar, A. B., Holsclaw, D. S., Porco, T. C., Smith, S. D., Whitcher, J. P., Margolis, T. P., Wong, I. G. 2010; 128 (8): 1022-1028

    Abstract

    To determine the incidence and associated risk factors for ulcerative keratitis in northern California.In this large-population, retrospective, cohort study, all medical records with diagnosis coding for corneal ulcers during a consecutive 12-month period were reviewed. Incidence rates were calculated using a dynamic population model. Multivariate relative risk regression was conducted to evaluate potential risk factors for ulcerative keratitis.Within the target population of 1 093 210 patients, 302 developed ulcerative keratitis. The incidence of ulcerative keratitis was 27.6 per 100 000 person-years (95% confidence interval, 24.6-30.9). The incidence of corneal ulceration in contact lens wearers was 130.4 per 100 000 person-years (95% confidence interval, 111.3-151.7), with an adjusted relative risk of 9.31 (7.42-11.7; P < .001) compared with non-contact lens wearers, who had an incidence of ulcerative keratitis of 14.0 per 100 000 person-years (11.7-16.6). Seven of 2944 people known to be infected with human immunodeficiency virus developed ulcerative keratitis, with 5 being contact lens wearers. The incidence of ulcerative keratitis in human immunodeficiency virus-positive patients was 238.1 per 100 000 person-years (95% confidence interval, 95.7-490.5), with an odds ratio of 9.31 (7.42-11.7; P < .001) compared with human immunodeficiency virus-negative patients, who had an incidence of ulcerative keratitis of 27.1 per 100 000 person-years (24.1-30.3).The incidence of ulcerative keratitis in this population is higher than previously reported. This may be owing to the increasing prevalence of contact lens wear.

    View details for Web of Science ID 000280909700010

    View details for PubMedID 20697003

  • The Effect of Biomicroscope Illumination System on Grading Anterior Chamber Inflammation AMERICAN JOURNAL OF OPHTHALMOLOGY Wong, I. G., Nugent, A. K., Vargas-Martin, F. 2009; 148 (4): 516-520

    Abstract

    To determine how a biomicroscope illumination system affects the grading of anterior chamber (AC) inflammation.Laboratory investigation.An artificial AC was designed to replicate optically a human AC and was filled with 5-mum polystyrene beads suspended in ethanol. A high-definition video eyepiece camera recorded the moving beads. Using image processing software, the main outcomes measures determined were the average number of beads in a 1 x 1-mm field at varying widths of the slit-beam.The volume of light and number of beads observed increased significantly as the slit-beam widened. Additionally, 3 separate biomicroscopes of identical make and model were found to produce different levels of luminance at the same aperture dial settings, influencing the number of beads observed, with the brighter biomicroscope yielding higher bead counts.Ability to count beads and perhaps the ability to count inflammatory cells in an inflamed eye depend on a number of factors, including the level of illumination and width of the slit-beam. This study demonstrated that the brighter the illumination and the wider the beam, the more beads were observed. This illustrates the importance of standardizing biomicroscopy, particularly where consecutive observations are used to make clinical decisions and in cases of multicenter clinical trials where clinical data are evaluated across different facilities.

    View details for DOI 10.1016/j.ajo.2009.04.027

    View details for Web of Science ID 000270538000008

    View details for PubMedID 19541282

  • Atopic disease and herpes simplex eye disease: A population-based case-control study AMERICAN JOURNAL OF OPHTHALMOLOGY Prabriputaloong, T., Margolis, T. P., Lietman, T. M., Wong, I. G., Mather, R., Gritz, D. C. 2006; 142 (5): 745-749

    Abstract

    To determine whether atopy is associated with herpes simplex virus (HSV) ocular disease.Retrospective, population-based, case-control study.Large, regional health maintenance organization (Northern California Kaiser Permanente).1,042,351 people over a one-year period.Electronic database search for HSV ocular disease and subsequent chart review determined study eligibility. Two age-matched control groups (one population-based and one clinic-based) were randomly chosen. Medical record review determined the presence of atopy. Severe atopic disease was defined by diagnostic code or illness requiring an emergency room visit, hospitalization, or treatment with a systemic corticosteroid.Presence of HSV eye disease, presence of atopy, and characterization of atopy severity.HSV eye disease was found in 172 patients. HSV cases had a greater prevalence of atopy (34%, 58/172) than the clinic-based (25%, 43/172) or the population-based controls (21%, 36/172, odds ratio (OR) 1.5, 95% confidence interval (CI) 0.9 to 2.6 and OR 1.9, 95%, CI 1.1 to 3.3, respectively). The association of HSV ocular disease with severe atopy was even greater, with a history of severe atopic disease in 13% (22/172) of patients with HSV ocular disease as compared with 6% (11/172) of patients in the clinic control group and 3% (5/172) of patients in the population control group (OR 2.0, 95% CI 0.7 to 5.9 and OR 4.8, 95% CI 1.6 to 19.2, respectively).Patients with HSV ocular disease are more likely to have a history of atopic disease, especially severe atopic disease, than age-matched controls.

    View details for DOI 10.1016/j.ajo.2006.06.050

    View details for Web of Science ID 000242142900005

    View details for PubMedID 17056358

  • Incidence and prevalence of uveitis in Northern California - The Northern California Epidemiology of Uveitis Study OPHTHALMOLOGY Gritz, D. C., Wong, I. G. 2004; 111 (3): 491-500

    Abstract

    To determine the incidence and prevalence of uveitis in a large, well-defined population in Northern California.Cross-sectional study using retrospective database and medical record review.A group of 2070 people within 6 Northern California medical center communities (N = 731 898) who had a potential diagnosis of uveitis.The patient database of a large health maintenance organization (2 805 443 members at time of the study) was searched for all patients who, during a 12-month period, had the potential diagnosis of uveitis. Detailed quarterly gender- and age-stratified population data were available. Medical records of patients who potentially had uveitis and who were members of the 6 target communities were reviewed by 2 uveitis subspecialists to confirm the diagnosis of uveitis and to establish time of onset. Demographic and clinical data were gathered for patients meeting the clinical definition of uveitis. Incidence rates were calculated by using a dynamic population model. Prevalence rates were based on the mid-study period population.Presence and date of onset of uveitis.At midstudy, the population for the 6 communities was 731 898. During the target period, 382 new cases of uveitis were diagnosed; 462 cases of uveitis were diagnosed before the target period. These data yielded an incidence of 52.4/100 000 person-years and a period prevalence of 115.3/100 000 persons. The incidence and prevalence of disease were lowest in pediatric age groups and were highest in patients 65 years or older (P<0.0001). The prevalence of uveitis was higher in women than in men (P<0.001), but the difference in incidence between men and women was not statistically significant. Comparison between the group of patients who had onset of uveitis before the target period (ongoing uveitis) and the entire cohort of uveitis patients showed that women had a higher prevalence of ongoing uveitis than men and that this difference was largest in the older age groups (P<0.001).In this largest population-based uveitis study in the United States to date, the incidence of uveitis was approximately 3 times that of previous U.S. estimates and increased with the increasing age of patients. Women had a higher prevalence of uveitis than men, and the largest differences were in older age groups.

    View details for DOI 10.1016/j.ophtha.2003.06.014

    View details for Web of Science ID 000189351800013

    View details for PubMedID 15019324

  • Nodular scleritis in a patient with pyoderma gangrenosum ARCHIVES OF OPHTHALMOLOGY Braun, M. M., Wong, I. G., Ta, C. N. 2002; 120 (12): 1763-1765

    View details for Web of Science ID 000179737900027

    View details for PubMedID 12470160

  • A novel technique for harvesting keratolimbal allografts from corneoscleral buttons AMERICAN JOURNAL OF OPHTHALMOLOGY Aldave, A. J., Wong, I. G. 2002; 134 (6): 929-931

    Abstract

    To describe a method for obtaining partial-thickness keratolimbal allografts from corneoscleral buttons to be used in corneal limbal stem cell transplantation.Description of device design and technique for use.Cyanoacrylate tissue adhesive, placed on the posterior side of a trephinated corneoscleral rim, is used to secure the allograft to a disposable acrylic sphere that is attached to a cylindrical base.After fixation of the corneoscleral rim to the acrylic sphere, keratolimbal allograft harvesting is performed as a continuous strip dissection with a 65 Beaver blade. This technique minimizes trauma to the epithelial stem cells, provides excellent stability of the corneoscleral rim during harvesting, and preserves the central corneal button.This method for obtaining keratolimbal allografts effectively provides tissue stabilization during harvesting, minimizing epithelial stem cell trauma and eliminating the need for whole donor globes.

    View details for Web of Science ID 000179738600030

    View details for PubMedID 12470775

  • Chronic uveitis following a streptococcal illness CANADIAN JOURNAL OF OPHTHALMOLOGY-JOURNAL CANADIEN D OPHTALMOLOGIE Knox, C. M., Wong, I. G., Love, P. 1999; 34 (2): 99-100

    View details for Web of Science ID 000080498000009

    View details for PubMedID 10321322

  • Bilateral Bartonella-associated neuroretinitis RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES Wade, N. K., Po, S., Wong, I. G., Cunningham, E. T. 1999; 19 (4): 355-356

    View details for Web of Science ID 000167042000020

    View details for PubMedID 10458308

  • Vitreitis and Waldenstrom's macroglobulinemia AMERICAN JOURNAL OF OPHTHALMOLOGY Knox, C. M., Wong, I. G., Howes, E. L., Barkin, A., Kearney, J. 1998; 126 (2): 314-315

    Abstract

    To describe vitreitis in a patient with Waldenström's macroglobulinemia.Case report and review of pertinent literature.A 90-year-old man developed vitreitis 10 years after a systemic diagnosis of a lymphoproliferative disorder. Numerous small, normal-appearing lymphocytes were seen on pathologic examination of the vitreous. He developed worsening lymphadenopathy and was diagnosed with Waldenström's macroglobulinemia after systemic review.Chronic lymphoproliferative diseases such as Waldenstrom's macroglobulinemia may cause vitreitis.

    View details for Web of Science ID 000075419500023

    View details for PubMedID 9727531

  • Reduction of cyclosporine dosage with ketoconazole in a patient with birdshot retinochoroidopathy AMERICAN JOURNAL OF OPHTHALMOLOGY Silverstein, B. E., Wong, I. G. 1998; 125 (1): 106-108

    Abstract

    To report the successful reduction of cyclosporine dosage with adjunctive ketoconazole in a patient with birdshot retinochoriodopathy.Case report.A 55-year-old woman treated with cyclosporine for birdshot retinochoroidopathy had ketoconazole (200 mg/day) added to her medical regimen. Her cyclosporine dosage was reduced to 40 mg per day from 200 mg per day, an 80% reduction. No toxic effect was observed during 12 months of follow-up nor was there progression of the birdshot retinochoroidopathy.Cyclosporine dosage may be reduced considerably in patients with uveitis who use adjunctive ketoconazole. The regimen appears to be safe and efficacious.

    View details for Web of Science ID 000071346100018

    View details for PubMedID 9437325

  • The value of routine dilated pupil screening examination ARCHIVES OF OPHTHALMOLOGY Batchelder, T. J., Fireman, B., Friedman, G. D., MATAS, B. R., Wong, I. G., Barricks, M. E., Burke, S., Beasley, L. 1997; 115 (9): 1179-1184

    Abstract

    We evaluated the cost-effectiveness of routine dilated fundus examination in improving visual outcomes. The cost of routine dilated fundus examination was related to the number of preventable cases of vision-threatening peripheral retinal disease. Patients with these diseases who had no risk factors were ascertained in a population of 1.75 million adults for a period of 6 months. Those whose last examination had been undilated were identified because only for them could routine dilated examination (RDE) have been substituted for undilated examination. The number of preventable cases was calculated for multiples of a 10% probability of prevention. The cost of RDE was determined from the number of undilated examinations in the same population and period and the cost of a single RDE. The number of patients who underwent undilated examination was estimated by random medical record review. The additional cost of a single RDE was determined from estimated examination times and payroll costs. Among patients without risk factors, 38 were identified for whom undilated examination rather than RDE had been performed. If prevention had been 10% effective, the substitution of 50,000 RDEs for undilated examinations costing the provider $433,000 would have been required per prevented case. These results suggest that most peripheral retinal diseases cannot be prevented by RDE. Routine dilated examination is an expensive test per prevented case. Published clinical guidelines lack evidence to recommend its use.

    View details for Web of Science ID A1997XV75900014

    View details for PubMedID 9298061

  • Microsporidial keratoconjunctivitis in a patient without human immunodeficiency virus infection AMERICAN JOURNAL OF OPHTHALMOLOGY Silverstein, B. E., Cunningham, E. T., Margolis, T. P., Cevallos, V., Wong, I. G. 1997; 124 (3): 395-396

    Abstract

    To describe a case of microsporidial keratoconjunctivitis in a patient without human immunodeficiency virus (HIV) infection.Case report. An epithelial corneal scraping from a woman with chronic bilateral keratoconjunctivitis was evaluated by Giemsa stain.Giemsa stain of an epithelial corneal scraping disclosed intracellular and extracellular spores characteristic of microsporidia. An HIV enzyme-linked immunosorbent assay (ELISA) test was negative. The signs and symptoms of the bilateral keratoconjunctivitis resolved after treatment with albendazole.Microsporidia may cause a chronic epithelial keratoconjunctivitis in the absence of HIV infection.

    View details for Web of Science ID A1997XU55700015

    View details for PubMedID 9439367

  • Cytomegalovirus-associated acute retinal necrosis syndrome AMERICAN JOURNAL OF OPHTHALMOLOGY Silverstein, B. E., Conrad, D., Margolis, T. P., Wong, I. G. 1997; 123 (2): 257-258

    Abstract

    To describe a case of acute retinal necrosis syndrome in which a polymerase chain reaction-based assay provided evidence for cytomegalovirus as the causative agent of the syndrome.Polymerase chain reaction-based assays were used to analyze a vitreous aspirate from a 70-year-old man with acute retinal necrosis syndrome. The specimen was tested for cytomegalovirus, varicella-zoster virus, and herpes simplex virus type 1 and type 2.The polymerase chain reaction assay for cytomegalovirus was positive, and polymerase chain reaction assays for varicella-zoster virus and herpes simplex virus type 1 and type 2 were negative.Cytomegalovirus may be a causative agent of acute retinal necrosis syndrome.

    View details for Web of Science ID A1997WG30500016

    View details for PubMedID 9186135

  • Supratarsal injection of corticosteroid in the treatment of refractory vernal keratoconjunctivitis AMERICAN JOURNAL OF OPHTHALMOLOGY Holsclaw, D. S., Whitcher, J. P., Wong, I. G., Margolis, T. P. 1996; 121 (3): 243-249

    Abstract

    We studied supratarsal injection of corticosteroid as a new therapeutic modality for treating severe vernal keratoconjunctivitis to determine its efficacy in treating patients refractory to all conventional therapy.Twelve patients with vernal keratoconjunctivitis resistant to all established therapy were prospectively studied by randomly assigning them to receive supratarsal injection of either short- or intermediate-acting corticosteroid. Relief of symptoms and resolution of clinical signs were evaluated. Patients were followed up to four years to identify side effects.All patients experienced dramatic symptomatic relief within one to five days, regardless of the type of corticosteroid injected. Marked decrease in cobblestone papillae was noted in 14.9 days (mean) after short-acting corticosteroid injection and 12.8 days after intermediate-acting corticosteroid injection (P = .65). Shield ulcers and limbal involvement resolved in one to three weeks, independent of the corticosteroid used (P = .90). No complications were observed with supratarsal injection of short-acting corticosteroid. One patient developed persistent increase of intraocular pressure after injection of intermediate-acting corticosteroid.The dramatic symptomatic and clinical improvement suggests that supratarsal injection of corticosteroid may be a valuable therapeutic approach to treating refractory vernal keratoconjunctivitis. Short-acting and intermediate-acting corticosteroids were equally efficacious. Because of the lack of intraocular pressure increase observed with short-acting corticosteroid, we favor its use in supratarsal injection.

    View details for Web of Science ID A1996TY95200001

    View details for PubMedID 8597266

  • METIPRANOLOL-ASSOCIATED GRANULOMATOUS IRITIS AMERICAN JOURNAL OF OPHTHALMOLOGY MELLES, R. B., Wong, I. G. 1994; 118 (6): 712-715

    Abstract

    Topical metipranolol therapy for primary open-angle glaucoma has been associated with anterior granulomatous uveitis in the United Kingdom. We studied granulomatous uveitis reactions to topical metipranolol 0.3% therapy for primary open-angle glaucoma in two patients in the United States.Two patients, aged 71 and 81 years, were given topical metipranolol 0.3% therapy for primary open-angle glaucoma.Both developed granulomatous uveitis. The iritis was associated with an increase in intraocular pressure in both patients and resolved on discontinuation of the drug. One patient was inadvertently rechallenged with metipranolol, and the iritis recurred.Topical metipranolol 0.3% therapy may be associated with the development of granulomatous uveitis and a paradoxical increase in intraocular pressure.

    View details for Web of Science ID A1994PW18900003

    View details for PubMedID 7977597

  • FUCHS SUPERFICIAL MARGINAL KERATITIS AMERICAN JOURNAL OF OPHTHALMOLOGY Bierly, J. R., Dunn, J. P., Dawson, C. R., OSTLER, H. B., Wong, I. G. 1992; 113 (5): 541-545

    Abstract

    We studied three cases of Fuchs' superficial marginal keratitis, an uncommon condition that is characterized by intermittent, recurrent episodes of ocular irritation accompanied by marginal infiltrates and that is followed by progressive marginal superficial stromal thinning. Usually, it has an indolent course with spontaneous remission, and good visual acuity is preserved. In advanced cases, a pseudopterygium develops in the area of marginal thinning. The pseudopterygium encroaches onto the cornea over a period of years, but spares the central cornea. In two of our three cases, the degree of thinning beneath the pseudopterygium became marked. This led to corneal perforation during pseudopterygium excision in one case, and after blunt trauma in the other. These complications indicate the need for special precautions when caring for these patients.

    View details for Web of Science ID A1992HR54100010

    View details for PubMedID 1575229

  • CATARACT-EXTRACTION - RISK-FACTORS IN A HEALTH MAINTENANCE ORGANIZATION POPULATION UNDER 60 YEARS OF AGE ARCHIVES OF OPHTHALMOLOGY Schwab, I. R., Armstrong, M. A., Friedman, G. D., Wong, I. G., CARPENTIERI, A. C., Dawson, C. R. 1988; 106 (8): 1062-1065

    Abstract

    Risk factors for cataract extraction in a young (less than 60 years of age) urban health maintenance organization population were evaluated in a case-control study. The subjects (72 case-control pairs) subscribed to the Kaiser Permanente Medical Care Program in the San Francisco Bay area and had cataract extraction between 1976 and 1980. All patients had visual acuity of at least 20/40 OU, documented before development of cataracts. Thirty-six (50%) of the 72 cataract extraction patients had at least one known risk factor for cataract formation, including trauma, intraocular inflammation, diabetes mellitus, syphilis, oral or topical steroid use, or previous eye surgery. Male patients were found to be a mean of 4.3 years younger than female patients, and diabetics were found to be a mean of 3.5 years older than nondiabetics. Variables found to be related to cataract extraction in univariate analysis included diagnosis of diabetes mellitus, a family history of cataracts, pulse rate, white blood cell count, and syphilis.

    View details for Web of Science ID A1988P575900021

    View details for PubMedID 3261164

  • SPONTANEOUS SCLERAL PERFORATION ASSOCIATED WITH PERIPHERAL MARGINAL CORNEAL DEGENERATION - A CASE-REPORT ANNALS OF OPHTHALMOLOGY Starr, M. B., Wong, I. G., OSTLER, H. B., Hetherington, J. 1981; 13 (2): 175-177

    View details for Web of Science ID A1981LL80300011

    View details for PubMedID 7247173

  • IMMUNOFLUORESCENT DETECTION OF ANTIBODIES TO OCULAR MELANOMAS ARCHIVES OF OPHTHALMOLOGY Wong, I. G., Oskvig, R. M. 1974; 92 (2): 98-102

    View details for Web of Science ID A1974T876000004

    View details for PubMedID 4136249

Conference Proceedings


  • THYGESON SUPERFICIAL PUNCTATE KERATITIS - MANAGEMENT USING IMMUNOMODULATORS Sherman, M. D., Holsclaw, D. S., Wong, I. G. ELSEVIER SCIENCE PUBL B V. 1994: 377-380

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