CAP Profiles

Bio

Bio

Professor Ruwan Amila Silva, MD, MPhil is board certified and fellowship trained vitreoretinal surgeon in the department of ophthalmology at Stanford University Medical Center. He received his BA in Neurobiology from Harvard University graduating Magna cum laude with Highest Honors. He then received his Masters of Philosophy (MPhil) in Neurobiology from Cambridge University in England. Following this, he received his medical degree from Stanford University’s School of Medicine. Dr. Silva completed his ophthalmology residency at the Bascom Palmer Eye Institute, the top rated eye hospital in the country. While there he was awarded the Heed Fellowship, the most prestigious national award for ophthalmology residents in the country. Dr. Silva returned to Stanford University to complete his vitreoretinal surgery fellowship where he was awarded the Ronald G. Michels Foundation Award, the nation’s highest honor for a retina surgery fellow. During his fellowship at Stanford he was also awarded the prestigious Evangelos S. Gragoudas Award by the Macula Society. Following fellowship, Dr. Silva remained at Stanford University's School of Medicine as an Assistant Professor of Vitreoretinal Surgery in the Department of Ophthalmology. Since 2015, he has been named one of “America’s Top Ophthalmologists” by Consumers’ Research Council of America.

Dr. Silva's clinical practice focuses mainly on macular degeneration and retinal vascular disease (such as diabetic retinopathy, retinal vein occlusions and central serous retinopathy). Surgically, he specializes in diseases of the vitreous and retina: including repair of retinal detachments, surgery for the macula (such as treatment of epiretinal membranes and macular holes) and correction of dislocated intraocular lenses. His research interests mainly involve developing novel therapies for these diseases and have resulted in over 50 combined peer-reviewed scientific manuscripts, book chapters and national meeting presentations.

Dr. Silva is a member of the American Academy of Ophthalmology, the Association for Research in Vision and Ophthalmology, as well as the American Society of Retina Specialists. He is a Board Certified Diplomate of the American Board of Ophthalmology.

Clinical Focus

  • Retina, Retinal Disease
  • Macular Degeneration, Drusen, Ocular injections
  • Vitreoretinal Surgery, Retinal Detachment
  • Epiretinal Membrane, Macular Pucker, Macular Holes
  • Diabetic Retinopathy, Retinal Vein Occlusion, Retinal Artery Occlusion
  • Myopia, Retinal Telangiectasis, Central Serous Retinopathy
  • Ophthalmology

Academic Appointments

Honors & Awards

  • Heed Fellowship Award, The Heed Ophthalmic Foundation (2012)
  • Ronald G. Michels Fellowship Award, The Ronald G. Michels Fellowship Foundation (2013)

Professional Education

  • Board Certification: Ophthalmology, American Board of Ophthalmology (2014)
  • Fellowship:Stanford Medical Center Retina Fellowship (2014) CA
  • Residency:Bascom Palmer Eye Institute (2012) FL
  • Internship:University of California Irvine (2009) CA
  • Medical Education:Stanford University (2008) CA
  • M.Phil., Cambridge University (UK), Neurobiology (2003)
  • BA, Harvard University, Neurobiology (2002)

Contact

  • Stanford Byers Eye Institute 2452 Watson Ct MC 5353 Palo Alto, CA 94303
    • Tel: (650) 723-6995
    Fax: (650) 497-7913

Publications

All Publications

  • Risk factors for respiratory depression in patients undergoing retrobulbar block for vitreoretinal surgery. Ophthalmic surgery, lasers & imaging retina Silva, R. A., Leng, J. C., He, L., Brock-Utne, J. G., Drover, D. R., Leng, T. 2015; 46 (2): 243-247

    Abstract

    To determine the risk factors for respiratory depression during retrobulbar block administration before vitreoretinal surgery.Prospective, observational case series of 113 patients undergoing monitored anesthesia care and retrobulbar block before vitreoretinal surgery at a tertiary medical center.Chin lift, jaw thrust, and bag mask ventilation were performed in eight (7.1%), nine (8%), and six (5.3%) patients, respectively. No patients required intubation. Age, sex, body mass index, history of obstructive sleep apnea, American Society of Anesthesiologists physical status level, and baseline oxygen saturation were not predictive of airway intervention. Of the four anesthetic agents utilized (midazolam, fentanyl, alfentanil, and propofol), only propofol and fentanyl were associated with an increased risk for clinically significant apnea. Use of three medications for sedation was associated with a 5.4-fold increase in the relative risk of requiring a respiratory rescue intervention.During preoperative sedation for retrobulbar block administration, the use of propofol, fentanyl, or a combination of three anesthetics is associated with a statistically significant increase in the risk for respiratory depression requiring resuscitation. [Ophthalmic Surg Lasers Imaging Retina. 2015;46:243-247.].

    View details for DOI 10.3928/23258160-20150213-22

    View details for PubMedID 25707051

  • Exogenous Fungal Endophthalmitis: An Analysis of Isolates and Susceptibilities to Antifungal Agents Over a 20-Year Period (1990-2010) AMERICAN JOURNAL OF OPHTHALMOLOGY Silva, R. A., Sridhar, J., Miller, D., Wykoff, C. C., Flynn, H. W. 2015; 159 (2): 257-264

    Abstract

    To describe the isolates and susceptibilities to antifungal agents for patients with culture-proven exogenous fungal endophthalmitis.Noncomparative case series.The clinical records of all patients treated for culture-proven exogenous fungal endophthalmitis at a university referral center from 1990 to 2010 were reviewed. Specimens initially used for diagnosis were recovered from the microbiology department and then underwent antifungal sensitivity analysis.The antifungal susceptibilities of 47 fungal isolates from culture-positive fungal endophthalmitis are reported. Included are 14 isolates from yeast and 33 from mold. The mean (±standard deviation) minimum inhibitory concetrations (MICs) for amphotericin B (2.6 ± 3.5 μg/mL), fluconazole (36.9 ± 30.7 μg/mL), and voriconazole (1.9 ± 2.9 μg/mL) are reported. Presumed susceptibility to oral fluconazole, intravenous amphotericin B, intravitreal amphotericin B, oral voriconazole, and intravitreal voriconazole occurred in 34.8%-43.5%, 0-8.3%, 68.8%, 69.8%, and 100% of isolates, respectively.Based on this laboratory study of isolates from exogenous fungal endophthalmitis, intravitreal voriconazole appears to provide the broadest spectrum of antifungal coverage and, as such, may be considered for empiric therapy of endophthalmitis caused by yeast or mold.

    View details for DOI 10.1016/j.ajo.2014.10.027

    View details for Web of Science ID 000348634300007

    View details for PubMedID 25449001

  • Reply. Retina (Philadelphia, Pa.) Moshfeghi, D. M., Silva, R. A., Berrocal, A. M. 2014; 34 (11)

    View details for DOI 10.1097/IAE.0000000000000352

    View details for PubMedID 25333627

  • Reply. Retina (Philadelphia, Pa.) Moshfeghi, D. M., Silva, R. A., Berrocal, A. M. 2014; 34 (8): e23-4

    View details for DOI 10.1097/IAE.0000000000000305

    View details for PubMedID 25054346

  • Antiphospholipid antibody-associated choroidopathy. Eye Silva, R. A., Moshfeghi, D. M. 2014; 28 (6): 773-774

    View details for DOI 10.1038/eye.2014.39

    View details for PubMedID 24603416

  • Retinal breaks due to intravitreal ocriplasmin. Clinical ophthalmology (Auckland, N.Z.) Silva, R. A., Moshfeghi, D. M., Leng, T. 2014; 8: 1591-1594

    Abstract

    Ocriplasmin represents a new treatment option for numerous vitreoretinopathies involving an abnormal vitreomacular interface. While the drug may circumvent the traditional risks of surgical treatment, pharmacologic vitreolysis is not devoid of risk itself. This report presents two cases, one of vitreomacular traction syndrome and the other of a full-thickness macular hole, both of which were treated with an intravitreal injection of ocriplasmin. Notably, in both cases, vitreomacular traction of the macula appears to have been alleviated; however, failure to completely relieve vitreoretinal traction from the peripheral retina generated retinal breaks with one patient eventually developing a macula-involving retinal detachment. Thus, even in instances of 'successful' pharmacologic treatment of vitreomacular traction, continued follow-up evaluation is essential.

    View details for DOI 10.2147/OPTH.S68037

    View details for PubMedID 25210426