The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Tech Corner
• Eye See
• The Importance of Saying Thank You (and How to do it Through Digital Marketing)
• Glacier PLUS™ UV, Precisely What You Need
• CE Corner
• Classifieds
• New Members
• Volunteer Corner
• SDCOS Announcements
• Upcoming Events

President’s Message March 2016

March is Save Your Vision Month!

Happy Save Your Vision Month everyone!  Before I begin going over what this month means for optometry, a few congratulations need to be given after this year’s California Optometric Association (COA) House of Delegates.  I would like to congratulate our own Dr. Amanda Dexter and Dr. Jason Tu for their nominations and acceptance of trustee positions on the COA Board of Trustees!  Having two optometrists from San Diego means we are incredibly well represented on the state level.  Very well done!  Congratulations also to Dr. Ketan Bakriwala for winning young optometrist of the year!  I am also happy to report the San Diego County Optometric Society (SDCOS) was awarded Project of the Year, recognizing our exceptional work for the Diabetes Walk.  Thank you to everyone who contributed time and effort to this project.  Special congratulations are due to Dr. Dave Sherman and Craig Hansen who co-host this effort every year.  Dr. Ed Hernandez also announced his continuing plans to run for Lieutenant Governor this year.  We need to give him all our support to help ensure optometry’s representation at the capitol!

March launches optometry’s national campaign to remind Americans of the importance of eye health and regular, comprehensive eye exams.  Known as Save Your Vision Month, this national health observance has been a staple in the profession for nearly 90 years.  The national awareness campaign was born out of a measure called Eyesight Conservation Week in 1924 and later revised to Save Your Vision Week in 1927. Proclaimed a national health observance week by President Lyndon B Johnson in 1963, Save Your Vision Week was changed to Save Your Vision Month by an American Optometric Association’s (AOA) House of Delegates resolution in 2005.

The 2016 Save Your Vision Month campaign focuses on working to educate both employers and employees about how to avoid digital eye strain in the workplace.  According to the AOA 2015 American Eye-Q survey, 58 percent of adults have experienced digital eye strain.  As optometrists, we need to educate our patients about the symptoms of digital eye strain, also known as computer vision syndrome.  These include eyestrain, headaches, blurred vision, dry eyes, and shoulder pain.  The AOA recommends five tips that can be easily implemented in most office spaces to help fight this epidemic:

• Follow the 20-20-20 rule:  Take a 20 second break, every 20 minutes and view something 20 feet away.
• Keep a distance:  The AOA recommends sitting a comfortable distance from the computer where you can easily read all text with your head and torso in an upright posture and your back supported by your chair.  Generally, the preferred viewing distance is between 20 and 28 inches from the eye to the front surface of the screen.
• View from a different angle:  Ideally, the computer screen should be 15 to 20 degrees, or about 4 to 5 inches, below eye level as measured from the center of the screen.
• Decrease glare:  While there is no way to completely minimize glare from light sources, consider using a glare filter.  These filters decrease the amount of light reflected from the screen.
• Blink often:  Minimize your chances of developing dry eyes when using a computer by making an effort to blink frequently.

Additional Findings on technology and eye health from the AOA Eye-Q Survey include:

• 59 percent of those surveyed responded that desktop computers and laptops were the devices that bothered them most.  Mobile phones were second at 26 percent, followed by tablets at 8 percent.
• 61 percent of people surveyed admit to using multiple digital devices at that same time.
• 56 percent responded that their primary use for digital devices is entertainment (reading, watching movies or shows, video games).
• 76 percent of people know that blue light from digital devices affects vision.

I would encourage our society’s optometrists to maximize on the exposure of this national campaign to reinforce the OD’s distinction as primary eye care doctors.  You can capitalize on the growing conversation in consumer media by factoring Save Your Vision Month into your practice’s marketing strategy.  Materials such as customizable articles, press releases, and social media content are available on AOA’s website.

The next COA event will be Legislative Day in Sacramento on April 20th.  I encourage everyone to join us on this day trip to the capitol.  There are important discussions that need to take place with our legislators regarding bills that could potentially threaten our profession, as well as bills that could allow the expansion of our scope of practice. Please let me know if you are interested, every doctor attending makes us stronger!

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Retina Corner Highlights from the recent American Academy of Ophthalmology meeting: DRCR.net Protocol T

By Nikolas London, MD, FACS

One of the hottest topics in retina is the relative effectiveness of the three available anti-vascular endothelial growth factor (VEGF) medications, bevacizumab, ranibizumab, and aflibercept. This is important not only for clinical care and optimizing outcomes for our patients, but also for financial reasons given the dramatic cost difference between the three medications. For the purposes of this article we’ll focus on the doses for diabetic macular edema (DME), which cost approximately $1950 for aflibercept, $1400 for ranibizumab, and $50 for bevacizumab. The Diabetic Retinopathy Clinical Research Network recently published the 1-year results of a large-scale comparison of these three medications for the treatment of DME, and Dr. John Wells III presented the results at the recent American Academy of Ophthalmology meeting. The study included 660 eyes with decreased vision due to DME at 89 sites across the country, and patients were randomized in equal groups to receive one of the three medications under a standard treatment protocol.

The authors evaluated the visual acuity (VA) outcomes as well as the change in central subfield thickness on optical coherence tomography (OCT). In short, the 1-year VA outcomes revealed no significant difference between the three options overall, but did suggest a greater efficacy for aflibercept in the subgroup of patients with worse baseline VA, defined as 20/50 or worse. In this group the average 1-year VA gain was +18.9 letters for aflibercept, compared to +11.8 letters for bevacizumab, and +14.2 letters for ranibizumab. This is an important difference, supported by anecdotal evidence from thought leaders. However a few things must be kept in mind. The groups may not have been truly similar at baseline. For one, patients could have been treated with focal and/or grid macular laser. As we well know, grid laser has a more substantial impact on a patient’s vision, and it may be inappropriate to lump these together without at least a better description of how the groups compared at baseline. Moreover, all three drugs were extremely efficacious, and while the outcome differences as a whole are not significant, the cost differences between them absolutely are. Just for the purposes of this study of a small number of roughly 224 patients per group treated for only one year, the real world cost of aflibercept would have been approximately $3,931,200, with nearly a million dollar savings for ranibizumab (approximately $3,136,000) and nearly a four million dollar savings for bevacizumab ($112,000). Considering that DME affects approximately 750,000 patients in the United States, the yearly cost difference between the medications is staggering.

My take-away from this study is that most patients do well regardless of the medication used and I will nearly always prefer bevacizumab at treatment initiation. If the response is suboptimal after about 3 injections it is reasonable to switch to ranibizumab or aflibercept. In suboptimal responders with poor initial VA these data will likely lead me to aflibercept. Once I achieve control of the DME I would attempt to transition back to bevacizumab in patients who can tolerate it. I also see a lot of benefit in focal laser and/or intravitreal corticosteroids in certain patients, but use particular caution in phakic patients or those with a history of glaucoma or ocular hypertension given the risk for cataract progression and steroid-induced glaucoma.

Thanks again for reading. Please don’t hesitate to contact me with any questions.

Best wishes, and until next time,
Nik

Nikolas London, MD
Retina Consultants San Diego, Poway, La Jolla, and Coronado
www.retinaconsultantssd.com
858-451-1911 (office)
415-341-5456 (cell)
nik.london@gmail.com (personal email)
retinaconsultantssd@gmail.com (RCSD email)

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Tech Corner Got Tech questions? We’ve got Answers!

Greetings, and welcome to Tech Corner, a new article for the San Diego View newsletter. Tech Corner is designed to provide you with a resource on any questions you may have when on the topic of computers, networks, HIPAA compliance, security and anything else technology  related! Every month we’ll be posting tips and news related articles we find, to help keep you informed and safe as possible. For our 1st article, here are some very basic steps you can take to help ensure the proper steps to keep your practice and patient’s private information more secure:

1. Make sure you and your staff do not take patient records or devices with patient data home. One simple mistake and that data can become publicly available.
2. Be aware of where patient data can be stored. Did you know that many copiers store data? If you change out copiers make sure to clear the data storage.
3. Stop storing information on local devices. The internet and the cloud storage it enables is truly your friend when it comes to HIPAA compliance.

For any specific questions you have, give us a call (619-825-4797) or email (SDCOS@GSWS.com) and let us know how we can assist. We are the experts and we’re here to help – no strings attached.

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Eye See written by Dr. Byron Y. Newman Confidence in Your Refraction

One day, many years ago, I finished my examination on a young woman and wrote out my prescription.  Her husband asked, “Would you mind if we went somewhere else for a second opinion?”

I as much as gave him permission and they were on their way.

As my day ended, I wrote out the Rx on an order and wrapped it up with the frame to send to the lab, when the phone rang.  I answered it, and there was an OD on the line.

He said, “I checked your patient of this afternoon, and I found a big difference in your Rx compared to mine, but I told the patient that it was very close so you wouldn’t lose her.”

I thanked him for that, and asked what his Rx was, and it was unbelievably different.

Now, what would you do?   Order the Rx from an unknown OD across town (I didn’t ask his name), or order your own?

Having confidence in my own work, I ordered mine.

When the patient came in to be dispensed, I asked her to come into the exam room for a moment, “I’d like to check something,”  I said.

So, I took a trial frame and put in the other guy’s Rx and showed her the chart.  “How does that look ?” I asked.

“Not so clear,” she answered.

Then I put my Rx in the trial frame and asked the same question.

She answered that it looked very clear and read off the 20/15 line with ease.

I dispensed glasses to a very happy patient….with my Rx.

Think about what you would do if this happened to you.

ConfIdence in your own abilities is where it’s at.

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The Importance of Saying Thank You (and How to do it Through Digital Marketing)

By Nancy Rausman, Managing Editor, EyeCarePro

This Valentine’s Day had me thinking about the importance of showing appreciation by regularly saying “thank you” to your patients. Giving your patients the recognition that they CHOSE YOU, when they could have chosen any other optometrist out there reinforces that they made the right decision. It builds trust, loyalty and goodwill and they will certainly remember it when it’s time for their next eye exam.

Also, creating a culture of gratitude leads to more overall success in any business. Research shows that customers spend more, employees accomplish more and vendors are more likely to pay in a timely manner when they feel appreciated by being thanked regularly.

When giving thanks be sure to:

• Be specific: Focus on exactly what you are thankful for.
• Be personal: Recognize that you are singling them out.
• Add value: Even a small favor will elicit an instinct of reciprocity where your patients will want to “pay you back” by spending more and returning for their optometric needs.

Here are six easy ways to show gratitude using digital marketing:

1. Create a nice thank you graphic that can be sent by email or as a postcard after a visit.
2. Run a Facebook thank you campaign.  Publicly thank patients that have come in by sharing a story or a photo of their new frames (with permission of course).
3. Share for them. Help your patients to succeed in their endeavors by liking their Facebook pages, sharing their content and reciprocating.
4. Hold a customer appreciation day in which you offer discounts or giveaways for loyal customers and spread the word through an integrated campaign on Facebook, email, website ads and direct mail.
5. Respond to reviews, both the good and the bad. Thank those that leave positive reviews and those that complain also.  Negative reviews give you insight on what you can do to improve your service. This is also a chance to (privately) offer them a consolation and tell that you appreciate that they took the time to tell you what bothered them rather than just walking away.
6. Offer social media exclusive deals such as a coupon code or special savings to Facebook friends.

Even though this is the holiday of love, expressing your gratitude to patients shouldn’t be a yearly occurrence, but a fairly regular one. Make these efforts part of your regular office procedures and everyone will benefit!

Nancy Rausman is the managing editor at EyeCarePro. Nancy is responsible for providing ECPs with educational content that helps them advance their practices through technology, management strategies and digital marketing. EyeCarePro is one of the leading providers of online marketing and practice improvement services in the industry, developing results-driven strategies for social media, search engine optimization, online and traditional offline marketing and sales growth initiatives.. EyeCarePro serves both industry and practices and is the only company of its kind solely focused on the optometric space. To contact: nancy@eyecarepro.net

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Glacier PLUS™ UV, Precisely What You Need

Last October, Shamir, manufacturer of premium Freeform® lenses, released their first AR Coating, Glacier PLUS™ UV, developed to help patients look their best, see their best and feel safe.

Glacier PLUS™ UV is a highly revolutionary premium coating due to three main components: the base, the hard coat and the AR coat.  The “base” is a Shamir Certified Blank; Shamir scientists developed the coating based on the specific properties and characteristics of their unique substrates.  The “hard coat” used for the Glacier PLUS™ UV coating is customized based on which particular molecular properties work best with Shamir’s specific lens materials, producing a unique Material Match Hard Coat process.  Glacier PLUS™ UV’s “AR Coating” stack was developed as a precise “recipe” based on each lens material and customized hard coat.

Glacier PLUS™ UV offers premium cosmetics by following a controlled “build” of the Shamir Application layers onto the Shamir blank, allowing patients to experience dramatically reduced cosmetic glare and reduced visual glare with Shamir’s innovative Matte Finish, as well as minimized “Rainbows” with their Newton Ring Reduction Technology, providing a clear distraction-free view of their eyes and crisp vision.

Glacier PLUS™ UV has a unique Slippery PLUS hydrophobic and oleophobic top layer that repels liquids and allows effortless cleaning for the patient.

“We are pleased to offer such a revolutionary AR Coating to the market.  The test results have been extremely positive and we are excited to expand into a different aspect of the market.  Glacier PLUS™ UV provides the patient with a cutting-edge, anti-reflective solution that truly helps to ReCreate Perfect Vision,” said Mark Becker, VP of Marketing and Strategic Partnerships.

Shamir Glacier PLUS™ UV is available on all Shamir Freeform® lens designs and provides another opportunity for practices participating in Shamir’s ReCreating Perfect Vision® (RCPV®) Rewards Program to earn rewards points.

For information regarding Shamir Glacier PLUS™ UV, contact Shamir’s Customer Service department at 877.514.8330.

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CE Corner We are committed to helping you fulfill your CE requirements through our local meeting with the support of our sponsors!

Featured Event Sponsors Event Sponsors

March 20, 2016 5-Hour CE: “Specialty Contact Lens Symposium & Workshop”

Speaker: Brooke Messer, OD, FAAO, FSLS

Dr. Messer received her doctor of optometry degree from Southern California College of Optometry, and subsequently went on to specialize in Cornea and Specialty Contact Lenses by completing a one year residency.

She is highly trained in fitting specialty contact lenses for keratoconus, post surgical corneas, and other corneal diseases, as well as multifocal contact lenses, orthokeratology contact lenses for myopia control and pediatric contact lenses.

Dr. Messer has authored articles for publications such as Contact Lens Spectrum and Review of Optometry, and enjoys teaching other doctors complex contact lens fitting techniques in classroom and clinical settings.

Dr. Messer is a fellow of the American Academy of Optometry, as well as the Scleral Lens Education Society, and is a member of the Contact Lens Society of America.

Outside the office, Dr. Messer loves to golf, hike and visit family back in her hometown of Dickinson, North Dakot

Topics: Scleral Lens Basics and Trouble Shooting (2hr) and Presbyopic Soft Contact Lens Options for Success (1hr)

Course Descriptions: 

Scleral Lens Basics and Troubleshooting:
This two hour course will initially cover basic scleral lens terminology, fitting techniques and examination flow.  Applicable patient populations and scleral lens benefits will also be reviewed. The lecture will then move into scleral lens customization, including toric peripheral curves, toric front surface optical corrections, multifocals and more.  Finally, the course will dive into some of the most common troubleshooting topics regarding scleral lenses.  Troubleshooting tips will cover improving patient vision, comfort and ocular health.

Presbyopic Lens Options for Success:
This one hour course will focus on patient selection and fitting of soft multifocal contact lenses.  Patient education and lens designs will be covered in depth, as well as lens fitting and basic trouble shooting techniques.  The lecture will include an update on the lens designs available in the monthly, two-week and daily disposable lens modalities, as well as tips on fitting soft toric multifocal contact lenses.

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Speaker: Brian Chou, OD

Dr. Brian Chou earned his doctorate of optometry at UC Berkeley in 1999, then completed a year-long fellowship at Jules Stein Eye Institute, UCLA, where he cared for the first several Intacs for keratoconus patients in the U.S. He has authored over 100 published manuscripts and serves on the editorial boards for Review of Optometry and Review of Cornea & Contact Lenses. Dr. Chou was an FDA clinical investigator for SynergEyes and continues to consult for several ophthalmic companies. He practices in the 4S Ranch area of San Diego at EyeLux Optometry, where he runs a referral-based keratoconus and irregular cornea contact lens clinic.

Topic: 7 Badass Contact Lens Hacks to Tame Keratoconus (1hr)

Course Description: The mainstay for restoring vision in keratoconus is simple – rigid contact lenses.  But successful treatment is often undermined by lens wearing discomfort and handling concerns, along with patient and doctor misconceptions.  This presentation delves into seven strategies to bring your keratoconus patients desirable outcomes.

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Workshop

3 stations to include hands-on scleral lens insertion & removal, UltraHealth & UltraHealth FC assessment and amniotic membrane insertion.  (1hr)

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Classifieds

FirstSight is pleased to announce availability of Optometric office space right next door!  We are looking for motivated Optometrists who are looking to step out on their own. This is a great turn-key opportunity – A FirstSight sublease offers the benefits of a private practice with little capital to get started. FirstSight will provide all office and top-rated optometric equipment including a Point of Sale system. All of these benefits enable optometrists to build a patient base while providing excellent customer care. We are looking for an Optometrist for our stand-alone office located next to Eyeglass World in Chula Vista which is opening in April 2016. If you are a driven Optometrist who is looking to run your own practice, please send a copy of your CV to odjobs@firstsightvision.net or you can contact Dr. Hoang Ho at 909.552.9860 for more details. (02/16)

San Diego private practice is in need of a fill-in OD on April 8th, 11th, 13th, and 15th with the potential to turn into a permanent part time position on Monday and Fridays.  Please contact 760-402-6518 or e-mail dr2020eye@yahoo.com (03/16)

Seeking Optometrist for Monday and/or Tuesday and/or Thursday. Must have own liability insurance coverage. Independent contractor position only. For a full-day schedule: First appt scheduled at 10am and last appt at 5pm. Lunch between 1-2pm. For a half-day schedule (can be arranged for Tues/Thurs only): First patient to be seen at 2pm and last appt scheduled at 5pm. Patients are scheduled every 20 minutes. Please attach resume if interested to collegegroveoptometry@yahoo.com (03/16)

Practice wanted Local Optometrist interested in purchasing a private practice in San Diego.  Please contact dr2020eye@yahoo.com (03/16)

San Diego private practice in need of fill in OD on Monday and Friday.  Please contact 760-402-6518 or e-mail dr2020eye@yahoo.com (03/16)

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Carl Zeiss Meditec: Scott Tucker scott.tucker@zeiss.com Carl Zeiss Vision: Anna Perrino anna.perrino@zeiss.com

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Welcome, new members!!

• Tracy Ho
• Cathleen Yuen
• Phuong Nguyen
• Risa Sugimoto
• Nicola Gough
• Margaret Nguyen
• Laheqa Suljuki
• Katherine Wang
• Jonathon Hall

Volunteer Corner

Monarch School Screening

Next Screening: March 14, 2016
Contact Dr. Bob Meisel for more information at rmeisel@netscape.net ; www.monarchschools.org

Lion’s Optometric Vision Clinic

Volunteer OD’s needed for flexible shifts throughout the year according to each doctor’s availability. OD’s unable to volunteer at the clinic can see patients at their office.
Call 619-298-5273, between 9-1:00 pm.,
Monday -Friday ~ 1805 Upas St, San Diego, CA 92103

Doctors interested in donating glasses to the Lions Optometric Vision Clinic (LOVC) please bring them to a CE meeting or contact Nancy-Jo at 619-663-8439 to make arrangements for delivery.

SDCOS keeps a list of all doctors willing to speak in front of groups about various topics, do home visits for patients, and assist in student mentoring. ODs interested in the Speakers Bureau, Home Visits, Student mentoring, and Low Vision OD’s, please contact Nancy-Jo at 619-663-8439

SDCOS Announcements

Attention SDCOS Members:

Any SDCOS member who submits an article to our monthly society newsletter is eligible to attend a 5-hour CE for FREE! Articles should be between 400 and 600 words, and may be edited for brevity, formatting, and relevance. Please submit articles to nancy-jo@sdcos.org.

• 2016 Continuing Education Schedule

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Continuing Education Seminars are at the Handlery Hotel 950 Hotel Circle North, San Diego, 92108.

Two-hour seminar, Thursday, 7:00 pm – 9:00 pm. Buffet meal included and served ½ hour prior to lecture.

• SDCOS Members free, COA/AOA Members $35.00, Non-Members $130.00.

Five-hour seminar, Sunday, 8:00 am – 1:30 pm. Buffet meal included and served ½ hour prior to lecture.

• SDCOS Members $90.00. COA/AOA Members, $90.00 Non-Members $325.00.

Upcoming Events

March 20th: 5 Hour CE: Specialty Contact Lens Symposium and Workshop
April 20th, 2016: Legislative Day, Sacramento, CA
May 19th, 2016: 2 Hour CE