By the time her son was 2 months old, Stephanie Mowery knew something was wrong with his vision.
“He couldn’t focus on anything, and his eyes shook really bad all the time,” she said.
Throughout his life, Evan, now 16, has not been able to see in color. He also has low vision and severe sensitivity to bright light. A never-ending series of special glasses and lens filters could never fully address his issues. And there was always the lingering, often-unspoken worry at the pit of Mowery’s stomach—would her son one day go blind?
“We tried to teach him Braille, which he hated,” she said. “And we bought our house based on it having a whole upstairs with a separate entrance Evan could use as an adult if he could not live independently.”

Mowery family photo
“It was very exciting and a huge relief,” said Mowery, who still tears up when she talks about receiving Evan’s long-awaited diagnosis. “It was emotional because it was confirmation that my baby won’t go blind.”
After 15 years of uncertainty, Evan’s diagnosis in April 2022 means he is now eligible for funding programs to cover the cost of related expenses, and he may be eligible for a clinical trial for achromatopsia in the future—potentially reversing some of the disease’s effects on his vision through gene therapy.
Genetic disease: The Medical Frontier
The human body has about 25,000 genes. Scientists only know what 5,000 of them do. Most patients who come to the URDC have already had the best genetic testing available and still don’t have answers because their condition stems from one of the 20,000 unknown genes.
“Rare disease is like a frontier,” said Francesco Vetrini, PhD, who co-directs the rare disease clinic with Conboy. “We are looking at a mystery, so we use all the arsenal available—the most advanced technologies.”

Erin Conboy, MD, and Francesco Vetrini, PhD, co-directors of the URDC
“We are like yin and yang,” Vetrini said. “She looks from the outside in, and I look from the inside out. In the end, we get the right diagnosis.”
Each case involves collaboration with a global network of researchers through gene matching databases to help the URDC find similar cases with the same affected gene. The URDC also works with the Indiana Biobank for genomic sequencing of bio-samples. The patient’s parents are often tested, as well, to uncover recessive gene mutations that may have been inherited.
“We’re all carriers for between one and five disorders, on average,” noted Conboy.
The novel methods the URDC uses result in deep phenotyping of each patient. When a case is potentially solved, it’s presented to the Genome Board at IU School of Medicine, which includes biomedical geneticists, genetic counselors, disease and genome experts, lab directors, analysts, rare disease postdocs and other interested physicians or researchers.
The URDC welcomes collaboration from IU colleagues who have interest and expertise in genomics and is currently seeking a postdoctoral fellow to join their team of rare disease super-sleuths.
“For someone who wants to put their PhD scientific knowledge into a field where you have a tangible impact on patients and families, this is rewarding work,” said Vetrini, who earned his PhD in medical genetics in Naples, Italy, and came to IU School of Medicine in 2018 as an ABMGG fellow in the Department of Medical and Molecular Genetics, focusing on clinical genomics and novel disease gene discovery.

In 2021, the URDC—in partnership with IU Health—was officially designated as a Rare Disease Center of Excellence by the National Organization for Rare Diseases (NORD). The discoveries made at the URDC increase the global medical community’s understanding of human genetic variants and rare diseases.
Because rare diseases, by definition, affect a small percentage of the population, funding is a challenge. Research grants typically go toward diseases affecting many people. The URDC welcomes donations of any size so the clinic can continue its work to find diagnoses for patients with mystery diseases.
Since 2020, 84 patients and 148 of their relatives have been enrolled in the clinic. Demand for the URDC’s services is increasing. Last year, the URDC received 88 referrals from physicians on behalf of their patients.
All of the clinic’s genetic sleuthing services are free to patients—a big relief for families that have already spent thousands in an attempt to manage an unknown disease.

Sometimes, as in Evan’s case, there are aids or therapies made accessible by a diagnosis. Other times, a disease is so rare that effective therapies do not yet exist. Even then, a diagnosis can bring closure and a more accurate prognosis of disease.
“A diagnosis is big deal for peace of mind,” Conboy said. “Once you know what you’re dealing with, your mind can stop all those anxious thoughts and move forward.”
Success in Ocular Genetics
Pediatric ophthalmologist Kathryn Haider, MD, first saw Evan Mowery when he was 5 years old. Although she suspected he had an inherited condition, Haider had no way to delve deeper. It would be years before genetic testing would become available.

18577-Haider, Kathryn
In 2019, Haider started an ocular genetics clinic at Riley Hospital for Children at IU Health with Conboy and genetic counselor Katie Anderson, MS.
“The idea was to have a collaborative place to start to understand inherited eye disorders more clearly and to get a genetic diagnosis in addition to a clinical diagnosis,” Haider explained.
Prior to the clinic’s opening, pediatric ophthalmologists at Riley were able to diagnose a genetic eye disease in just 4 percent of suspected cases. Since the clinic’s opening, they have successfully diagnosed 55 percent of those cases.

Evan needed the deep sleuthing only the URDC could provide. As Vetrini delved into whole genome sequencing, he discovered the other misspelling lurking in what scientists call “junk DNA”—DNA that does not code for genes.
The URDC team found the “smoking gun” to finally solve Evan’s case.

Evan Mowery, 16, wearing new glasses for achromatopsia
That’s big news for a 16-year-old who thought he would never be able to drive.
“The URDC completely changed our lives,” Mowery said. “We never dreamed we would have answers. Now we know Evan will be able to live independently. As a parent, the weight that takes off is huge. It’s such a relief.”