San Diego County Optometric Society
The San Diego View
Inside this Issue:
- President’s Message
- Retina Corner
- Eye See
- CE Corner
- Volunteer Corner
- SDCOS Announcements
- Upcoming Events
Greetings and Happy New Year 2019! I hope that each of you has had a relaxing holiday season with your families and friends, and I wish you success in the coming year. As your new San Diego County Optometric Society president I want to thank you for giving me the opportunity to help make this the best possible year in our excellent optometric society.
Over the years I’ve gained so much professionally and personally from my membership in SDCOS. It is indeed an honor for me to be in the position to give back. We have a great group of doctors on our Board of Directors and I am excited for all that we are going to accomplish together.
My gratitude goes to Dr. Michael Morgan for his steadfast leadership as President last year. I have admired all of the attention to detail and leadership responsibilities he’s undertaken and completed. He has solidly earned our Society’s nomination for COA Young Optometrist of the Year. Congratulations to you, Dr Morgan!
Thank you to the entire Board of Directors for the dedication to our profession that you constantly project. You continually make SDCOS the finest optometric society anywhere, with excellence in community service, exemplary optometric leadership, and service to our membership with continuing education and professional enhancement. Additionally, the entire Society membership must be thanked and congratulated for choosing to become and remain members. It is our common desire to have a rich professional life outside our individual practice environments, and for this reason SDCOS remains a treasured organization for all of us.
As your Society president, I am committed to maintaining the tradition of SDCOS and performing to the highest level of service, both to our member doctors and to the public. I will maintain the legacy of decades of great optometrists who worked to create the fine society that we have today. Our Board of Directors has already planned out our 2019 meetings, which include six two-hour evening CE events and three five-hour weekend CE events. These gatherings are complete with a delicious meal, an expert speaker, and important fellowship with your colleagues. Many great ophthalmic businesspeople and vendors attend our meetings, allowing us access to their companies’ products and services. I encourage you to attend all of the CE meetings this year!
In addition, please plan on contributing to the many volunteer outreach programs within our Society that will allow you to provide community service via eyecare to the public. This includes our Lions Optometric Vision Clinic and our Monarch School Screenings, to name just two. Moreover, you can join us for our annual COA Legislative Day in Sacramento when we come together to encourage our elected state assemblypersons and state senators to support our profession. So many of our members currently volunteer and are actively involved, and your participation effects positive change. Thank you to those who currently volunteer. I encourage all of our members to take advantage of these community service and leadership programs: our community will benefit from your dedication to the profession of optometry in San Diego County, and I’m certain you will find them to be personally fulfilling as well.
Finally, I bring up a challenge to our membership that is vitally important to the morale and health of our Society: Invite your colleagues to join. Introduce yourself to new members who do join. Don’t be shy! Our Society is fortunate to have a diverse mix of newly minted and veteran practitioners. Each group has the opportunity to benefit from each other’s unique knowledge and skill sets. Professional camaraderie is the essence of local society membership and expands each member’s network. Through your active SDCOS relationships, enjoy your profession of optometry and strive to optimize your own career.
It is an honor and a privilege to serve as your SDCOS president. I look forward to all that we will accomplish together this year. I will make myself available for any questions, comments, and ideas so our society can continue to grow and thrive. I am confident that together we will have a fantastic year!
Home Monitoring for AMD
By Nikolas J.S. London, MD FACS
Director of Clinical Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla
In the last Retina Corner we discussed the benefits of a Mediterranean diet for lowering the risk of developing advanced AMD, but like-it-or-not, patients will still convert. When they do, it is our obligation to catch that conversion as early as possible – ideally the very minute that choroidal neovascular membrane (CNVM) broke through Bruch’s membrane ready to wreak havoc on the overlying retina. The gold standard for this would be daily OCT, or better yet OCT angiography, but that is obviously not practical. So, we are relegated to home screening maneuvers looking for the development of symptoms consistent with exudative AMD. Sort of like the fire department waiting to hear a neighbor scream “smoke” before running out to put out a fire in your home. Amsler grids and testing reading vision are better than doing nothing, but there is certainly a better way, which I would like to discuss this week.
First, a quick comment on what a fairly poor job we are doing detecting the development of CNVM formation in our AMD patients. Clinical trial data from the past decade, derived from several studies with large sample sizes, reveal that only a limited number of eyes with newly diagnosed CNV were detected when VA was still relatively good. The proportion of eyes with 20/40 or better VA at CNV diagnosis ranged from 13% to 41%. A recent large, real-world retrospective cohort analysis to characterize VA at the time of new-onset wet AMD diagnosis in the first or second eye was recently published in Ophthalmology. This study looked at 160,000 eyes and showed that the mean baseline VA at the time of wet AMD diagnosis was 20/83, and less than 35% of all eyes had 20/40 or better. Even when the patient was already seeing a retina specialist for treatment in the other eye, VA in the fellow eye at the time of conversion was a disappointing 20/80.
This is a far cry from where we want to be, but we can certainly do better. One example which likely represents the best current option is the ForeseeHome device from Notal Vision. This device is covered by insurance and quantitatively and objectively tests metamorphopsia in high-risk AMD patients – it is an Amsler grid on steroids. A few years ago, the AREDS2-HOME study, also published in Ophthalmology, compared the ForeseeHome device with traditional home monitoring. A total of 1,520 patients were randomly assigned to test their eyes daily with the device plus standard testing or to standard care alone. Among the participants who used the ForeseeHome device, 94% maintained 20/40 or better VA at the time of CNV detection, compared with 62% of patients in the control arm using traditional detection methods. The study was stopped early due to the clinically significant efficacy of the ForeseeHome program.
We should do everything we can to maximize visual outcomes for our AMD patients and I believe that the ForeseeHome offers the best option we currently have available. Back to the fire analogy, it is like putting a fire detector in your home that alerts the fire department instead of waiting for your neighbors to see the smoke billowing out of your windows. Like anything else, it should not be over-prescribed and is only indicated for high-risk dry AMD patients (AREDS category 3), but should probably be a part of any initial conversation with those patients.
Thanks again for reading. Please don’t hesitate to contact me with any questions.
Best wishes, and until next time,
Nikolas London, MD
Retina Consultants San Diego, Poway, La Jolla, and Coronado
firstname.lastname@example.org (personal email)
email@example.com (RCSD email)
written by Dr. Byron Y. Newman
THE ECONOMICS OF MIGRAINE
“Migraine headaches produce an enormous financial burden on society,” reported Stuart O. Schweitzer, PhD about 20 years ago in a supplement to “Managed Care Magazine. He pointed out in the article that it was primarily because of their high incidence among people in the middle of their careers.
In a more recent Internet report by Richard Lipton, MD, FAHS, “Overall, migraine affects about 18% of American women and 6% of American men, making it by far the most common neurologic disorder. Women are three times more likely to have migraine than men, and it is most common between the ages of 18 and 55. These are the peak productive years in a person’s life, which is part of the reason why migraine has such an enormous economic burden—It disrupts your education, professional and personal life at a pivotal time.” Apparently, little has changed in the last few years.
Migraine sufferers use twice the amount of prescription drugs and visit doctors and emergency rooms twice as often as those who don’t have the disorder.
One study estimates the loss of productivity in the U.S. to be between $5.6 billion to $17.2 billion per year because of missed work. The average migraine sufferer misses two days of work per year. Some who suffer from persistent migraines work during a migraine attack, which they say lowers productivity. It is estimated that migraines are the reason for 36 million days of bed rest, plus 21.5 million days of restricted activity. Other statistics show 3.2 million lost school days among children and young adults.
Researchers have set the national annual bill for lost wages due to migraine related diminished productivity at between $5.6 billion and $17.2 billion, a range based on an estimated need for 3 million “bed days” per year and an additional 2.7 million restricted activities for men and 18.8 days for women..
The economic loss from Migraine exceeds that of Type 2 diabetes.
Check out Dr. Newman’s website, www.thehumorfactory.com!!!
We are committed to helping you fulfill your CE requirements through our local meeting with the support of our sponsors!
Featured Annual Sponsors
January 17th, 2 Hr: Refractive Symposium
Speakers: SDCOS annual sponsors:
NVISION – Gordon Schanzlin New Vision Institute – La Jolla LASIK
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.
Optometry practice for sale in an upscale area of beautiful San Diego. This solo location practice has annual revenue of $524,000 and still has potential to grow. This approximate 1,200 square foot office was recently renovated. Equipment is in excellent condition and includes a Humphrey Visual Field and OCT Cirrus Photo 600. Full scope of practice includes adult and pediatric examinations, contacts, and specialty contact lenses, dry eye, ocular disease and a moderate population of glaucoma patients. Over 1,500 patients examined last year. Beautiful optical with a wide array of frame lines. EMR/EHR certified using Compulink software system. Complete Sale/Buy Out. This practice is set up for a turnkey transition. Please email CV or questions to firstname.lastname@example.org (03/19)
Practice for sale: North County Carlsbad “Upscale” Practice established in 1982. Great opportunity to buy a practice in a well-desired location with great visibility and walk-in traffic. Only two miles to the ocean! The owner is interested in an immediate sale or will consider a buy-in or possibly merge with another practice. I am looking to retire but will consider a part-time position to make the transition easier. Center is well established with Vons market and Movie theatres as anchors. Don’t miss this opportunity to own your dream practice! Email:email@example.com or call 760-310-8492 (01/19)
Dr. John Fitzpatrick, the Society Optometrist Relations Liaison, offers a unique service to the San Diego Optometric community. Several lists are kept on file for doctors seeking the following, or any combination: • full-time work • part-time work • fill-in work • purchase a practice • sell a practice • partner in a practice. There is no charge for this service. To put your name on the list, please contact Dr. John Fitzpatrick at firstname.lastname@example.org
Monarch School Screening
Monarch Screening: Monday February 25th
Monarch Exams with VSP Mobile Clinic: March 11-12th. We still need at least one more doctor to help on Monday from 8-2!!
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. Please contact Dr. Bob Meisel if you are interested or have any further questions!
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
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.
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 the society office at 619-663-8439 or email email@example.com
Welcome, New Members!
- Stephanie Le
- Krista Gardner
- Kathryn Ordonez
- Alexandra Scovill
Please update your information on www.eyehelp.org
Phone: 619 663 8439
Fax: 800 643 8301