The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Tech Corner
• Eye See
• Eyes of Hope^®
• CE Corner
• Classifieds
• Volunteer Corner
• SDCOS Announcements
• New Members
• Upcoming Events

President’s Message March 2017

March, also known as “Save Your Vision” month, launches optometry’s national campaign to remind Americans of the importance of eye health and regular, comprehensive eye exams.  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.

More recently, you may have noticed radio ads and TV commercials promoting the “Think About Your Eyes” campaign. This marketing strategy from the AOA is intended to be a Public Service Announcement to educate the general public about the importance of eye care and vision in a manner that is easy to digest and promote understand of what it means to see well. In addition to the usual message of getting your eyes checked routinely, the “Think About Your Eyes” campaign educates people about the risks of binocular vision abnormalities in children as well as pathology related the diabetes and other systemic conditions that warrant an evaluation regardless of whether a person thinks their eyes are “okay.” If you look up the campaign online, you’ll find valuable resources on commonly encountered eye problems, both medical and visual. In addition, there are testimonies from teachers and other professionals discussing the importance of vision in learning for children as well as misconceptions parents have about their children’s eyes. To illustrate the success of this campaign: “Think About Your Eyes” advertising reached 95 percent of Americans between the ages of 25-49 in 2014 – totaling over 150 million American consumers.  This is the largest public exposure for vision care, the AOA, and the profession of Optometry – ever!

The campaign also focuses on educating both employers and employees about how to avoid digital eye strain in the workplace.  According to the AOA, 58 percent of adults have experienced digital eye strain.  As optometrists, it is our responsibility to educate our patients about the symptoms of digital eye strain, also known as computer vision syndrome.  These symptoms 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.

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 “Think About your Eyes” into your practice’s marketing strategy.  Materials such as customizable articles, press releases, and social media content are available on AOA’s website.

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Retina Corner SAPPHIRE: Evaluating Suprachoroidal Triamcinolone for Retinal Vein Occlusions

By Nikolas London, MD, FACS

Figure. The Clearside Biomedical suprachoroidal needle. A. Photo of the needle on the hub or a syringe. B. The suprachoroidal needle penetrating the sclera of a pig eye. The hub of the needle is designed to end in the suprachoroidal space. C. Immunofluorescence showing the trans-scleral injection site (arrow) as well as 500 nm particles in suprachoroidal space of a pig eye following a suprachoroidal injection.

One of my favorite things about working at my practice is our strong legacy of clinical research and innovation. Our group is nearly always involved in the major trials evaluating the next generation of medications and surgical equipment for our patients. These are wonderful opportunities for us to be on the cutting edge of science as well as provide our patients access to drugs that will hopefully maximize their visual outcome. Moreover, most studies cover all expenses, meaning no insurance considerations, copayments, or deductible to worry about. Patients often even are compensated for their time, and enjoy contributing to science. A win-win all around.

This month I wanted to discuss one of the more interesting studies we are just starting to recruit for. The SAPPHIRE study is being conducted by Clearside Biomedical, and is a phase III, randomized, controlled, multicenter trial evaluating the safety and efficacy of suprachoroidal triamcinolone (SC-TA) in conjunction with intravitreal aflibercept (Eylea) in subjects with retinal vein occlusion and macular edema. The main goal is to show that Eylea combined with SC-TA is superior to Eylea alone.

The rationale for this study is that the two drugs should be synergistic in combination. While Eylea (and other anti-VEGF agents) are very safe and effective in reducing macular edema associated with RVO, they are required nearly monthly, creating a significant treatment burden. Corticosteroids, on the other hand, also effectively reduce edema, counteract many more inflammatory markers than VEGF, and are usually dosed every three to four months. Together, the two approaches offer the potential for a more rapid and a better clinical outcome, and will likely require less frequent dosing. Moreover, the suprachoroidal route of administering the corticosteroid may minimize the risk of common corticosteroid side effects, including ocular hypertension and cataract.

Newly-diagnosed patients with be randomized evenly to one of the two groups, and followed monthly. All subjects will be treated at the beginning of the study and then on an as-needed basis at the subsequent monthly visits based on established retreatment criteria.

One thing that makes this study special is the use of a novel needle and injection technique to deliver triamcinolone to the suprachoroidal space (Figure). This needle was developed by Clearside Biomedical and has been evaluated with promising results in multiple phase two studies. The needle is designed to penetrate the sclera safely and painlessly and is remarkably accurate in its delivery of drug. The potential of this is exciting, particularly considering the early research being done with stem cells and gene therapy.  While those applications are likely decades away, this delivery system will likely make a more immediate impact on a number of our patients, including those with retinal vein occlusion as in the SAPPHIRE study, as well patients with uveitis, macular degeneration, and diabetic retinopathy. Advances like this are not only fun to participate in, but make me excited to witness its evolution.

If anyone has a candidate for this trial or one of our trials on wet macular degeneration, geographic atrophy, the implantable telescope, diabetic macular edema, or diabetic retinopathy, please do hesitate to contact me to schedule a screening visit.

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!

PREPARING FOR THE BIG ONE

By Dave Tuckman from Golden State Web Solutions, Inc. (www.GSWS.com)

We’ve seen some large data breaches over past couple of years. One good example is the OPM (Office of Personnel Management) breach in 2014 that ultimately affected approximately 21.5 million records. As individuals, there really isn’t anything we can do to prevent something like this from happening: The OPM already had our personal data, and were responsible for keeping it secure. This breach was their failure, not something we had control over.

Despite who’s at fault, and our lack of control to prevent a situation like this from happening; we can still better prepare (and protect) ourselves, were something like this were to take place. That’s what this article designed to assist with. Please find below some steps each of us can do to best watch for any possible bad activity associated with your private information.

1. HAVE (AND KNOW) WHO YOUR TECHNOLOGY RESOURCE IS
In same way it’s best to know who your mechanic is before the car breaks down, it’s the same with technology. We now have enough technology in our daily lives, that it only makes sense to have a resource that can assist when you have questions and/or find yourself in a rough spot. It doesn’t need to be an official IT services company, it can easily be a family member or friend. If you have no friends or family, I will be your friend (my contact info is below). The important thing is that you know who to contact BEFORE something happens. This step alone can save a lot of time and grief.

2. HAVE A PLAN (WERE SOMETHING TO HAPPEN)
Work to identify and itemize what private information you know you need to protect (i.e. credit cards, passwords, private records, etc. The can be updated anytime, so it doesn’t need to be perfect. If just needs to help identify what we know to be mindful of. Often when something like this happens, it is very emotional. Having a bit of a plan prior smoothens the whole experience quite a bit.

3. PAY WITH A CREDIT CARD (NOT A DEBIT CARD)
You are better protected when using a credit card vs. a debit card to make online purchases. Debit cards will immediately withdraw the money from your account. Were something to happen, you would need to work with the bank directly, not only report the malevolent activity, but go through the steps to get the money in your account restored. This can potentially tie your money up for an extended period of time. Credit card purchases will go to your statement, where it can be reviewed prior to payment. Additionally, credit cards are protected by the Fair Credit Billing Act, helping to limit liability if your information is stolen or used without authorization.

4. CLOSELY CHECK CREDIT CARD STATEMENTS
Your credit card and financial institution statements are a complete summary of all activity for that specific billing period. There shouldn’t be any surprises in there, and don’t dismiss any transactions just because they are a smaller amount. Often, with a compromised credit card, the initial transactions will be small (i.e. a $1 donation to cancer research). This is to confirm if the information is valid for transactions. Once those get approved, larger transactions will soon follow (see tip #1 above). Take the time to look at each transaction and confirm it is legitimate. The bad guys are hoping you won’t take the time and just pay the bill. Don’t give them what they are hoping for.

5. GET A CREDIT CHECK EVERYONE 4-6 MONTHS
A popular target for hackers is your credit (that is the gateway to the bigger purchases). Running regular checks will show if there is anything unusual on your report. When I once had mine checked, it showed Direct TV marked me as a delinquent account. Considering I never had an account with Direct TV that seemed odd. It was easy enough to get cleared up, but had I not had it checked, I wouldn’t have known at all.

Next month, we’ll look at what to do (and resources available) in the event your private information does get are compromised and you have some cleaning up to do. In the meantime, if you have any questions and/or would like additional information, you can reach Dave directly at (619-905-4468) or email dave@GSWS.com.

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DIGITAL EYE LAB a division of ABB OPTICAL GROUP

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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 Annual Sponsors

MARCH 16, 2017 2 Hour
SynergEyes presents Brian Chou, OD

Topic: Navigating the Choppy Waters Ahead to Flourish in Contact Lens Practice

Speaker:

• Dr. Brian Chou

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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.

Classifieds

Are you a Doctor with an entrepreneurial drive? A sublease with FirstSight is a great turn-key opportunity for a Doctor to start their own practice with minimal capital investment! Our Santee sublease is available now! This practice can generate upwards of $200,000 in revenue a year! Email odjobs@firstsightvision.net or call 800-841-2790 with any questions about this amazing opportunity. (03/17)

Make your next career move with Regency Eye Care at our El Cajon practice! Our mission is to provide our patients with the highest level of quality service and ensure our doctors have the support to assist in that goal. As one of our full-time doctors, your will receive a comprehensive benefits package including a competitive salary, professional liability insurance, medical benefits, vacation, bonus, and more! Email regency odjobs@firstsightvision.net or call 800-841-2790 with any questions about this amazing opportunity. (03/17)

Are you a Doctor with an entrepreneurial drive? A sublease with FirstSight is a great turn-key opportunity for a Doctor to start their own practice with minimal capital investment! Our El Cajon sublease is available now! A sublease practice can generate upwards of $200,000 in revenue a year! Email odjobs@firstsightvision.net or call 800-841-2790 with any questions about this amazing opportunity. (03/17)

FOR SALE Busy, thirty-five year practice in La Mesa, near I-8, in a single story professional building with excellent visibility The office is 2600 sq. feet (expandable), three lanes, two special testing rooms, large optical, and roomy, central clerical area. A finance service has already packaged the loan information to help with financing, the doctor is willing to carry part of the loan and work part time as needed for easy transition and patient retention. The staff is excellent and very efficient. Contact: drvidal@2020lamesa.com (03/17)

For Sale Well maintained Retina camera.  Zeiss Stratus OCT (Needs a new bulb) you are welcome to come in and take a look and try out both. Best offer accepted. Located in San Diego if interested, please call or text 760-402-6518 or email dr2020eye@yahoo.com (03/17)

PT and FT Optometrist Positions we are looking for a part-time general optometrist with 3 years’ experience or residency training to include working Saturdays to join our busy Carlsbad, CA group practice. This position needs to be filled by mid-February. We are also looking for a full time optometrist with either 3 years’ experience or residency training in vision therapy and rehabilitation for neurological disorders.  Our office offers full scope optometric care including hard fitting contacts and medical care, vision therapy for special needs populations, visual rehabilitation for patients with stroke and brain injury, and we have all the latest in diagnostic equipment and a great staff of 22 employees. Please email your CV, references and salary requirements to drdaniel@drsofoptometry.com (03/17)

FT / PT / or Fill in Optometrist Looking for Full or Part time OD to work at moderately busy practice(s) Flexible schedule, convenient hours, great environment and staff In addition to providing high quality and comprehensive eye care the ideal candidate with have strong work ethic, great personality, professional chair-side manner, high energy, motivated, and possess a can-do attitude to deliver exceptional patient care. Please email your CV, references and salary requirements to keane.kmp@gmail.com (03/17)

Dr. John Fitzpatrick, the Society Optometrist Relations Liaison, offers a unique service to the San Diego County Optometric community.  Several lists are kept on file for doctors seeking the following, or any combination thereof:  • positions   • fill-in work • part-time work • full-time work • to purchase a practice • to fill positions • to partner in a practice • to sell a practice There is no charge for this service.  Please contact Dr. John Fitzpatrick at E-mail:odjobs@sdcos.org to put your name on the list.

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Volunteer Corner

Monarch School Screening

Next Screening: Friday March 24th 08:00 – 1:00pm: WE NEED 3 MORE DOCTORS TO HELP!
Next Exams: Thursday and Friday April 13th and 14th 08:30 – 3:00pm: WE NEED 1-2 MORE DOCTORS ON THE 13th!
Contact Dr. Bob Meisel for more information at rmeisel@netscape.net ; www.monarchschools.org

Lion’s Optometric Vision Clinic

ATTENTION LOVC VOLUNTEER DOCTORS
FREE 5-hour CE for SDCOS Members (maximum of 2 CE’s per year)
$70 CE for Non-Members choice (maximum of 2 CE’s per year)

VOLUNTEER DOCTORS needed for flexible shifts throughout the year. 9-1:00 pm. Monday -Friday 1805 Upas St San Diego, CA 92103
Can’t volunteer at the clinic? See patients in your office. Call 619-298-5273.

DONATE GLASSES
Please bring to a CE meeting or contact the society office at 619-663-8439 for arrangements to pick up.

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

In Memoriam 2016

• Dr. Richard Clarke
• Dr. Robert Heller
• Dr. Dennis Leake
• Dr. Russell Everrett Love
• Dr. W. Keith Wilson
• Dr. Jerry Lieblein (2017)

• Click here for most recent SDCOS Board Meeting Minutes
• Click here for the new 2017 CE schedule!

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Welcome, new members!!

• Dena Shahani
• Lisa Kamino

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Upcoming Events

• March 16th: 2 Hour CE
• March 24th: Monarch School Screening
• April 8th: UCSD Health Fair
• April 13-14th: Monarch School Exams
• July 23rd: Annual SDCOS Golf Tournament