The field of Oculofacial Plastic Surgery evolved as a result of the trauma inflicted on soldiers during WWII, and the conflicts in Korea and Vietnam which included a high incidence of ocular and peri-ocular injuries. Military physicians returned to civilian practice with new skills to pass on to their surgical students which led to the founding of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) in 1969.
William B. Stewart, MD, FACS, was appointed the CPMC residency’s first Director of Orbital and Oculoplastic Surgery in 1977 at a time when the subspecialty was expanding considerably in application and expertise. Later, from 1996 to 2000, he served as Chair of the Department of Ophthalmology.
In 1968 Dr. Stewart received his MD from the University of Minnesota Medical School. He trained in general surgery at the University of Colorado Medical Center and was a surgery resident at UCSF prior to his active-duty service in the US Air Force from 1970 – 72. He completed a residency in Ophthalmology at CPMC 1973-75, followed by fellowships at Moorfields Eye Hospital with Mr. John Wright, FRCS, renowned orbital surgeon in London, and at the Bascom Palmer Eye Institute in Orbital and Ophthalmic Plastic and Reconstructive Surgery with Richard R. Tenzel, MD, a Charter Fellow of ASOPRS. This prepared him for a return to CPMC in 1977 where he created a new service and curriculum as Director of Orbital and Oculoplastic Surgery.
Influenced by Drs. Crowell Beard and Marvin Quickert and their fellows at UCSF, Stewart integrated residents into his private practice as did Drs. Lewis Lauring at Letterman Army hospital, and Andrew Markovitz from the Naval Hospital.
Ocularist Steven Young, BCO provided additional depth to the curriculum, having been recruited by Dr. Bruce Spivey, to join the department in 1975 where he continues to serve as a faculty member.
Residents benefited from Stewart’s published work as he co-authored a textbook, Orbital Disease: A Practical Approach, in 1981 and as Editor, Manual of Ophthalmic Plastic and Reconstructive Surgery, 4th edition 1984 for the American Academy of Ophthalmology. He also edited Surgery of the Eyelid, Orbit and Lacrimal System, Ophthalmology Monographs, American Academy of Ophthalmology, volumes 1,2,3 1993-1995, and co-edited the Atlas of Orbitocranial Surgery in 1999.
Among those CPMC residents and fellows who trained under Stewart’s leadership are; Drs. Don Ellis, in San Diego, Jonathan Kim, Professor of Ophthalmology and the Director of the Ocular Oncology Service at the USC Roski Eye Institute, Peter Levin, former Fellowship Director of the Stanford Training Program in Ophthalmic Plastic Surgery, Todd Shepler, in Austin, Texas and Mike Peterson in Missoula, Montana.
Stewart’s international influence has been profound due to his long affiliation starting in 1983 to present day with the Aravind Eye Care System in India where he helped to establish the department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthetics. His former fellow, Dr. Usha Kim currently serves as Head of that Department. In 1999 Stewart was invited to give the Wendell Hughes lecture at the annual joint meeting of ASOPRS and AAO. Dr. Hughes is considered the father of contemporary ophthalmic plastic and reconstructive surgery. Most recently, in 2019, Dr. Stewart was the recipient of the Dr. G. Venkataswamy Endowment Oration Award in commemoration of the life and work of Dr. V at the Aravind Eye Hospital in Madurai, India.
In 2000, after 12 years of leading the Oculoplastic Surgery Service at Highland Hospital, Rona Z. Silkiss, MD, FACS, was appointed Chief, Division of Oculofacial Plastic Surgery at CPMC. She is a graduate of the Northwestern University Feinberg School of Medicine, completed a residency in Pediatrics (Children’s Hospital of Los Angeles and the New York Hospital) and Ophthalmology (the Stein Eye Institute). She is board certified in both Pediatrics and Ophthalmology. She completed her Oculoplastic and Orbit Surgery fellowship under the tutelage of Dr. Henry Baylis at the UCLA, Stein Eye Institute, one of the early leaders in aesthetic oculofacial plastic surgery. She is also a Fellow of the American Ophthalmological Society.
Dr. Silkiss has received numerous awards for her research including the first US clinical trial of the use of Rituximab for thyroid eye disease. She demonstrated that Rituximab and Tocilizumab deplete orbital B cells in TED and that Rituximab depletes B cells in the thyroid gland of treated patients. She was the first to report structural CNS changes in the brains of patients with active thyroid eye disease as evidenced by MRI. Silkiss, with Drs. Jayson Koppinger and Timothy Truong conducted the first clinical trial on the use of Epidiolex for the treatment of Benign Essential Blepharospasm. She has been honored with two resident teaching awards, the William B Spencer Lectureship and Northwestern University Department of Ophthalmology Alumni Lecture and has been awarded the American Academy of Ophthalmology Achievement, Senior Achievement and Distinguished Service award.
The Plastics didactic curriculum instituted by Stewart and Silkiss was unique. UCSF and CPMC residents attended lectures and wound/suture labs together. These were taught by specialists from UCSF, Stanford, CPMC and private practice surgeons including James Langham. This joint lecture series is a laudable example of cooperation among specialists.
The residency’s influence in oculoplastic surgery education has also continued at Highland Hospital in Oakland where Dr. Silkiss served as Chief of Service from 2004-2016 when her practice partner and residency Program Director, Dr. Kasra Eliasieh was named Chief of Service.
Under Silkiss’ leadership residents have been encouraged to participate in research and writing projects throughout their training resulting. This has resulted in over 90 award winning peer reviewed and invited Oculoplastic publications, including Best Research Paper at the American Academy of Ophthalmology, 2010. She has also mentored several award-winning resident Barkan research projects. One such Barkan project, authored by Drs. Maria Govorkova, Tatyana Milman and Rona Silkiss, was awarded the Merrill Reeh Award from the American Society of Ophthalmic Plastic Surgery in 2019 for their work on inflammatory markers in xanthelasma.
Special recognition is due to Dr. Stuart Seiff, who has served for many years as Director of Fellowship in Ophthalmic Plastic and Reconstructive Surgery which has graduated outstanding oculoplastic surgeons including: Drs. Laryssa Dragan, Fort Collins, Colorado, Orin Zwick, Baltimore, Maryland, Bryan Seiff, Dover, Delaware, Eve Moscato, San Francisco, California, Harmeet Gill, Toronto, Canada, Louis Savar, Beverly Hills, California, David Russell, Vacaville, California, Lilly Wagner, Rochester, Minnesota, Isaiah Giese, Portland, Oregon and Loreley Smith, 2020-2022 Fellow.
Considerable appreciation is given to volunteer faculty members including Drs. Robert Peralta, Eve Moscato, David Russell, Devron Char and Gary Aguilar. As the Ophthalmology Department has come of age, the Oculoplastic faculty remains strong, seeking to inspire the scientific curiosity of the residents and enable them to think critically. They are committed to the transfer of their surgical skills, knowledge base and medical moral compass to new generations of ophthalmologists. We are privileged to work together in the interest of outstanding patient care and resident education.