Clinical Focus

  • Ophthalmology
  • Ocular inflammatory disease, uveitis and cornea

Academic Appointments

Administrative Appointments

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

Honors & Awards

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

Professional Education

  • Fellowship:University Of Iowa Hospitals and Clinics GME Training Verifications (1974) IA
  • Residency:University Of Iowa Hospitals and Clinics GME Training Verifications (1973) IA
  • Internship:University Of Iowa Hospitals and Clinics GME Training Verifications (1970) IA
  • Fellowship:UCSF Graduate Division - Fellowships (1977) CA
  • Medical Education:George Washington University Medical School (1969) 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.


2017-18 Courses


All Publications

  • Complications of Uveitis: The Northern California Epidemiology of Uveitis Study. Ocular immunology and inflammation Gritz, D. C., Schwaber, E. J., Wong, I. G. 2017: 1-11


    To describe the uveitis complications in a large, community-based cohort.Retrospective, community-based, cross-sectional cohort study analyzing complications and associations with complications.A total of 844 cases of uveitis were found; 342 were new-onset, and 462 were prior-onset. In total, 29.5% of patients were affected by one or more complications associated with age, gender, course, and anatomic location of uveitis. Visual loss was experienced by 19.1% of patients and was associated with age, course of disease, and anatomic location of uveitis. Of the patients who developed glaucoma or elevated intraocular pressure over 30 mmHg, 3.9% (n = 33) were related solely to uveitis; 5.2% (n = 44) had an unclear or combined mechanism; and 1.8% (n = 15) were related solely to steroid response. Cystoid macular edema was associated with course of disease and anatomic location of uveitis.Complications affect a significant portion of uveitis patients, and are often associated with demographic and clinical factors.

    View details for DOI 10.1080/09273948.2016.1247174

    View details for PubMedID 28112975

  • The Epidemiology of Herpes Simplex Virus Eye Disease in Northern California OPHTHALMIC EPIDEMIOLOGY Stanzel, T. P., Diaz, J. D., Mather, R., Wong, I. G., Margolis, T. P., Gritz, D. C. 2014; 21 (6): 370-377
  • Perivascular exudates in frosted branch angiitis. Ophthalmic surgery, lasers & imaging retina He, L., Moshfeghi, D. M., Wong, I. G. 2014; 45 (5): 443-446


    Three cases of young, minimally symptomatic patients found to have vitritis and extensive perivenous vitreous exudates resembling frosted branch angiitis are presented. Optical coherence tomography showed that these exudates appear to be extravascated from the vasculature. The material persisted over 1 year on immunosuppressive therapy, suggesting that its resolution should not be a treatment end point. These cases add to our understanding of the spectrum of clinical findings in frosted branch angiitis.

    View details for PubMedID 25215872

  • Perivascular Exudates in Frosted Branch Angiitis OPHTHALMIC SURGERY LASERS & IMAGING RETINA He, L., Moshfeghi, D. M., Wong, I. G. 2014; 45 (5): 443-446

    View details for DOI 10.3928/23258160-20140908-04

    View details for Web of Science ID 000347297300013

    View details for PubMedID 25215872

  • Prefoveal Vitreous Condensation in Chronic Inflammation OPHTHALMIC SURGERY LASERS & IMAGING RETINA Paulus, Y. M., Wong, I. G., Sanislo, S., Moshfeghi, D. M. 2014; 45 (5): 447-450

    View details for DOI 10.3928/23258160-20140806-03

    View details for Web of Science ID 000347297300014

    View details for PubMedID 25153658

  • Prefoveal vitreous condensation in chronic inflammation. Ophthalmic surgery, lasers & imaging retina Paulus, Y. M., Wong, I. G., Sanislo, S., Moshfeghi, D. M. 2014; 45 (5): 447-450


    Uveitis can produce a host of signs throughout the eye. Cylinders, snowballs, condensations, and snowbanks in the vitreous have been described. The authors report two cases of chronic ocular inflammation with a novel sign of a prefoveal white vitreous condensation. One patient is a 6-year-old child with intermediate uveitis and positive results for PPD, and the second is a 65-year-old woman with bilateral recurrent intraocular lymphoma. Both cases responded well to vitrectomy and treatment of the inflammation.

    View details for DOI 10.3928/23258160-20140806-03

    View details for PubMedID 25153658

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


    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


    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


    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


    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

  • 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


    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


    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


    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


    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


    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


    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


    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



    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

  • THYGESON SUPERFICIAL PUNCTATE KERATITIS - MANAGEMENT USING IMMUNOMODULATORS 6th International Symposium on the Immunology and Immunopathology of the Eye (IIPE) Sherman, M. D., Holsclaw, D. S., Wong, I. G. ELSEVIER SCIENCE PUBL B V. 1994: 377–380
  • 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


    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



    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


    View details for Web of Science ID A1981LL80300011

    View details for PubMedID 7247173


    View details for Web of Science ID A1974T876000004

    View details for PubMedID 4136249