A Happy Person Again
Patient: Marcella Velasco
Sight Restored: 2005
After a diagnosis of acute myeloid leukemia in 2000, followed by difficult treatment, including a stem cell transplant, and then missing more than a year of work, Marcella Velasco just wanted to get back to her life. But graft-vs-host disease (GVHD) appeared, as it eventually does in more than half of those who receive donated bone marrow or peripheral blood stem cells during a life-saving transplant.
GVHD is a cruel condition that may appear soon after a transplant, or much later. In addition to acting on the intended cancer cells, the grafted blood cells attack the patient’s host tissue as well, causing painful symptoms in the skin, eyes, mouth and stomach.
Ms. Velasco, now 45, recalls how vulnerable she was. “Going home after the transplant was scary because I was still so sick,” she says. “I felt like a turtle without a shell. My parents came to help take care of me. About a year after the transplant, I started having really bad symptoms in my right eye, as well as ulcers in my mouth.”
The ulcers made it difficult to eat, but the symptoms in her eye made her miserable. Ocular GVHD, as it is known, affects 60-80 percent of those with chronic GVHD. “My eye was always dry and painful,” she says. “It felt like there was sand in it, and I was very sensitive to light. Even in the middle of the night, my eye was so uncomfortable that it woke me up.”
During the day, simply going outside caused eye pain. “The light came around my sunglasses,” she says. Like many people, Ms. Velasco uses a computer at work and could barely look at the screen. She constantly poured saline drops into her eye, had tear duct plugs inserted and tried medication. “Nothing worked, and my eye became so irritated that I could hardly open it. After three years of symptoms, my oncologist finally recommended Boston Foundation for Sight.”
That is when Ms. Velasco’s life began to turn around. “I met Dr. Jacobs, who started me on eye ointment,” she says, referring to Deborah S. Jacobs, MD, BFS medical director. “But she soon told me I was a candidate for BostonSight® PROSE treatment. When she put in a trial device, the relief was instantaneous. I said ‘please don’t take it out!’ I almost started crying.”
Alan Kwok, OD, took over her care from there, and Ms. Velasco was amazed at the impact PROSE had on her vision, comfort and life. “I have no pain, and I’m no longer sensitive to light,” she says. “I’m a happy person again.”
Her eye has had ongoing problems; she developed a cataract, required surgery and, as a result, a new PROSE device. “Dr. Kwok always wants to be sure the device is perfect for me,” she says, noting that she has developed low-pressure glaucoma in her right eye and a cataract in her left eye.
Drs. Kwok and Jacobs keep a close watch on her ocular GVHD. “Marcella’s right eye sometimes flares and becomes symptomatic,” Dr. Kwok says, noting that is the nature of the disease. “We treat it as best we can and try to keep it under good control.”
“I can’t say enough about the staff at Boston Foundation for Sight,” says Ms. Velasco. “Everybody there is so caring. It’s an oasis for your eyes. And it’s a community; I’ve met so many interesting people while I’m sitting in the family room. You feel relieved to know that you’re not the only person with this problem.”