Uveitis Solutions: Recovery Means Independence

Remember being eighteen? Ryan Wullschleger was enjoying independence as a freshman at Humboldt State, competing in swimming and exploring possible majors. During his spring semester, however, he suddenly experienced aching, acute weakness, and then vision loss. A rare autoimmune syndrome was impairing Ryan’s body, leading to near-blindness within weeks.

“Student health services and the local ophthalmologist were coming up empty, and I was going blind,” Ryan remembers.

Tenacity and Expertise

An internist finally diagnosed his autoimmune syndrome and referred Ryan to UCSF’s Francis I. Proctor Foundation for Research in Ophthalmology, where he began immediate uveitis treatment. Inflammation triggered by Ryan’s systemic disorder was causing his retina to detach.

Ryan moved back to his childhood home.“At first I needed help with simple things like getting to the shower,” he says.“It was hard, and I knew I had to stay focused. I enrolled in community college and ordered my books on tape. Friends and family helped make it work.”Weekly and then monthly for nearly two years, Ryan’s parents drove him from Visalia to UCSF. Swimming kept up his spirits.

Meticulous Care

“I always knew I was getting the absolute best care at Proctor,” says Ryan. “Everything was checked multiple times by multiple doctors.”

Three uveitis specialists – Nisha Acharya, MD, MS; John Gonzales, MD; and Thuy Doan, MD, PhD – manage patient conditions at Proctor’s uveitis clinic, assisted by cornea and external disease specialists Thomas Lietman, MD, and Jeremy Keenan, MD, MPH, as well as three fellows.

“Our team is totally committed to overcoming the challenges of this disease. We use all the technologies and resources at our disposal in pursuit of better outcomes for uveitis patients around the world.” – Dr. Nisha Acharya

“Our team is committed to enabling uveitis patients to reach their full potential in life and not be limited by their disease,” says Dr. Acharya.“We partner with patients and strive to find the optimal therapy to control each ocular inflammation while preserving quality of life.”

Patient Ryan Wullschleger is joined by two friends on a recent trip to Oakland.

“I always knew I was getting the absolute best care at Proctor.” – Patient Ryan Wullschleger

Teamwork Restores Sight

Drs. Acharya and Gonzales supported Ryan’s sight recovery with drug therapies and meticulous monitoring. Jay Stewart, MD (Department of Ophthalmology), surgically inserted tiny corticosteroid implants into Ryan’s eyes to reduce inflammation over many months.

More than a dozen UCSF retina, glaucoma, and pediatric ophthalmology specialists help uveitis patients with complications to retain their sight. Rheumatologists, internists, dermatologists, pulmonologists, and pediatricians assist the team in tailoring care for diverse cases.

Innovative Medicine

The current mainstay of treatment for noninfectious uveitis is corticosteroids. Proctor’s clinicians are at the forefront of using and assessing novel treatments such as immunosuppressants and biologic agents to restore sight. This approach means that hundreds of patients each year avoid steroid complications, which can be debilitating in themselves.

Medical specialists in the northwest United States and beyond count on this team to help patients with the most complex uveitis cases. But Proctor does more. It also tracks, studies, and compares the long-term outcomes of treatments, developing evidence to improve care and overcome the disease.

Two Dreams Achieved

After receiving medical therapy and the time-release implants, Ryan’s vision gradually returned. Today he can recognize people from about twelve feet away, and he can read books with regular size print. Some damage is thus far irreversible, leaving him unable to drive. His syndrome has attacked again, but immediate treatment protected his fragile sight.

Fortitude, the support of his family, and six years of expert care at UCSF have shepherded Ryan to restored sight and renewed independence. He completed his college degree in May 2016. Throughout his ordeal Ryan kept on swimming, even when he couldn’t see the far end of the pool.