The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Tech Corner
• Eye See
• CE Corner
• Classifieds
• Volunteer Corner
• SDCOS Announcements
• New Members
• Upcoming Events

President’s Message October 2017

This month’s message is going to be short and sweet: We need you to represent Optometry to our legislators! In years past, California ODs descended upon the state legislature in Sacramento to educate our representatives about how we can provide greater care for our fellow citizens. This year, COA has decided to change the plan and focus on meeting legislators in their local districts. Personally, I think this is a wonderful idea that will save the COA resources and allow more doctors to meet with the Assembly Members in their home districts to forge relationships. While the previous Legislative Days provided a great experience in traveling to the capitol and understanding how the legislative process works, this time COA plans to focus on educating Assembly Members at home about the needs of Optometrists and the patients that we serve. This year’s Local Legislative Day is being held on Saturday, October 7 at 6 PM at Gordon Biersch Brewery in Mission Valley. Please take this time to come out and meet our local Assembly Members, let them know the importance of the care we provide to their constituents, and what we need from them in order to continue to provide affordable, accessible eye care to our patients. I hope to see all of you there!

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Retina Corner Gore-Tex Sutured Intraocular Lens

By Nikolas London, MD, FACS

The vast majority of the time cataract surgery goes extremely well, but there are occasions where the capsule tears significantly and/or a lens dislocates into the vitreous and a retina surgeon is consulted to help. Over the past few years, we have refined an innovative new technique for surgical fixation of an intraocular lens (IOL) in eyes in these situations. It is a deceptively simple and elegant technique that involves the use of Gore-Tex suture to suspend an IOL from the sclera similar to a hammock. There is four-point fixation and only small wounds, resulting in excellent centration and minimal ocular morbidity. The use of extremely strong Gore-Tex suture means that it is highly unlikely for the suture to break and the IOL to dislocate again.

As this technique gains popularity (this is currently my go-to surgery in these cases), I wanted to share it with you for this month’s article. Again, this is relevant to cases where there is likely insufficient residual lens capsule to place a lens in the bag or sulcus. Of course, an anterior chamber IOL can be placed, but this is less than ideal for cosmetic reasons, involves a large wound, and can lead to damage to the cornea and/or trabecular meshwork.

While several IOLs can be used for this surgery, the best is probably the Akreos AO60 (figure 1), which has two haptics on each side of the IOL, each with a small eyelet. These eyelets are critical to the surgery, with suture threaded through them. The lens is also made of a flexible acrylic, making it easy to fold and insert into the eye through a small corneal wound.

The surgical steps are summarized in figure 2. In short, the patient is placed under anesthesia and the eye is prepped and draped in sterile fashion. A toric IOL marker is used to mark the cornea 180 degrees apart and an adjacent conjunctival peritomy is created to expose the sclera. After minimizing bleeding with diathermy, small-gauge cannulas are placed 3mm from the limbus at the corneal marks and complete vitrectomy is performed. The dislocated IOL or residual lens material is removed, as needed. Next, small sclerotomies are created through the pars plana 4mm away from the cannulas, also 3mm from the limbus. The Akreos IOL is then prepared by passing the Gore-Tex suture through the eyelets on either side of the IOL. The IOL is then folded and inserted into the eye through a small corneal wound. The ends of the suture coming from each eyelet are then pulled through the appropriate sclerotomies on each side of the eye and tied securely over the sclera. The ends of the suture are trimmed and the knots are buried into the wounds. The instruments are removed and the conjunctiva is sutured closed.

I have done several of these surgeries now, and have been very pleased with the results. While not applicable to all situations, it is certainly a technique to be kept in mind, and typically results in an optimal cosmetic and functional outcome.

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!

WHAT TO KNOW ABOUT THE EQUIFAX BREACH (AND WHY IT MATTERS)

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

These articles usually get written about 2 weeks before being published, which makes for an interesting dynamic when talking about something (like Equifax) that is in the news cycle. It will be interesting to see how the Equifax breach story will have evolved by the time this article gets to you. Heck, with the way things are going, we very well may see another organization (bigger perhaps) get hacked before this article even gets read…

This month, we take a look at the breach itself, As explained by the FTC. The complete article can be found here: https://www.consumer.ftc.gov/blog/2017/09/equifax-data-breach-what-do

WHAT HAPPENED
If you have a credit report, there’s a good chance that you’re one of the 143 million American consumers whose sensitive personal information was exposed in a data breach at Equifax, one of the nation’s three major credit reporting agencies.

Here are the facts, according to Equifax. The breach lasted from mid-May through July. The hackers accessed people’s names, Social Security numbers, birth dates, addresses and, in some instances, driver’s license numbers. They also stole credit card numbers for about 209,000 people and dispute documents with personal identifying information for about 182,000 people. And they grabbed personal information of people in the UK and Canada too.

WHAT TO DO
There are steps to take to help protect your information from being misused. Visit Equifax’s website, www.equifaxsecurity2017.com.

• Find out if your information was exposed. Click on the “Potential Impact” tab and enter your last name and the last six digits of your Social Security number. Your Social Security number is sensitive information, so make sure you’re on a secure computer and an encrypted network connection any time you enter it. The site will tell you if you’ve been affected by this breach.
• Whether or not your information was exposed, U.S. consumers can get a year of free credit monitoring and other services. The site will give you a date when you can come back to enroll. Write down the date and come back to the site and click “Enroll” on that date. You have until November 21, 2017 to enroll.
• You also can access frequently asked questions at the site.

Here are some other steps to take to help protect yourself after a data breach:

• Check your credit reports from Equifax, Experian, and TransUnion — for free — by visiting annualcreditreport.com. Accounts or activity that you don’t recognize could indicate identity theft. Visit IdentityTheft.gov to find out what to do.
• Consider placing a credit freeze on your files. A credit freeze makes it harder for someone to open a new account in your name. Keep in mind that a credit freeze won’t prevent a thief from making charges to your existing accounts.
• Monitor your existing credit card and bank accounts closely for charges you don’t recognize.
• If you decide against a credit freeze, consider placing a fraud alert on your files. A fraud alert warns creditors that you may be an identity theft victim and that they should verify that anyone seeking credit in your name really is you.
• File your taxes early — as soon as you have the tax information you need, before a scammer can. Tax identity theft happens when someone uses your Social Security number to get a tax refund or a job. Respond right away to letters from the IRS.

As always, if you have any questions and/or would like additional information, contact me directly at (619-905-4468) or email dave@GSWS.com.

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Eye See written by Dr. Byron Y. Newman Stay tuned for next month!

 

Check out Dr. Newman’s website, www.thehumorfactory.com!!!

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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

October 19th: 2 HR CE

Brittany McMurren, OD BioTissue, and Optovue ETM Software Presentation
Michael Kling, OD Dry Eye Presentation

Social Hour: Hosted by SDCOS

See 2017 and 2018 CE schedules.

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.

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Classifieds

San Diego Coastal Del Mar/Carmel Valley Modern Equipment, Furnishings, Frames and TI’s Turn-Key Great Location.  An affluent area with highly educated, multicultural backgrounds near many high-tech companies.  Great opportunity in one of San Diego’s finest planned communities. Great school district. Exclusive Optometry, Ophthalmology, Optical Lease. Moderate gross on 2 days per week. Reasonably priced. Bank Financing Available. Currently fulfilling a rare full-time opportunity at a Medical Clinic, so I can only be there part-time. Send serious inquiries only to myowncoasteyepractice@gmail.com (10/17)

Full-time position available for an Associate Optometrist with a strong medical background large group practice includes 3 Optometrists, 3 Ophthalmologists, full-sized optical and state-of-the-art equipment in a brand new clinic in Downtown Chula Vista. Job duties include medical co-management of ocular pathology patients along with routine eye care. Requirements include prior residency or minimum 3-year experience in a medical eye care setting, current CA Licensure, and Professional Liability Insurance. Basic Spanish language skills preferred. Competitive Salary If interested please email a cover letter and CV to Olga Ramirez at castillejoseyeinstitute@hotmail.com (11/17)

Seeking permanent Associate Optometrist 4-5 days a week in our private practice in Poway.  Enjoy a comfortable pace with our all-digital equipment.  Staff performs pre-testing, including retinal photos.  Please email resumes/questions to MichelleKingOD@gmail.com (11/17)

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 • purchase a practice • fill positions • partner in a practice • sell a practice. There is no charge for this service. Please contact Dr. John Fitzpatrick at jpfod@aol.com to put your name on the list.

Volunteer Corner

Monarch School Screening

Monarch School Fall Exams: October 17th and 18th
We need doctors to help on all these dates, please contact Dr. Meisel if you are interested!!

Contact Dr. Bob Meisel for more information at rmeisel@netscape.net ; www.monarchschools.org

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Volunteer opportunities with Tzu Chi Foundation:

• October 22nd in Mountain Empire

Please contact Dr. Bob Meisel for more information

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Lion’s Optometric Vision Clinic

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

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Flying Samaritan Optometry Clinic – Tecate, Mexico

The SDSU Flying Samaritans are asking for any optometrists that would be willing to volunteer on Saturdays and accompany other volunteers to their optometry clinic in Tecate, Mexico.  It is not necessary to be fluent in Spanish, a translator can be provided. The clinic is located about 40 miles southeast of SDSU. Their goal is to provide free eye exams, glasses, and access to other free medical benefits to the underserved communities of Baja California. They are looking for volunteers for the following dates: August 19th, September 23rd, October 21st. Please contact Dr. Bob Meisel if you are interested or have any further questions!

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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.

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

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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

• Click here for most recent SDCOS Board Meeting Minutes
• Click here for the 2017 CE schedule!
• Click here for the new 2018 CE schedule!

Welcome, new members!!

• David W. Hansen
• Justin Kozloski
• Andrew Romeril
• Queen Thach
• Kelly Tran
• David Wong

Upcoming Events

• October 7th: SDCOS Legislative Advocacy Day
• October 19th: 2 hr CE