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
Some years ago, I was talking with another optometrist about the monetary value of COA membership when she made a poignant statement that’s stayed with me ever since. It was a simple point that propelled me to pay my dues without reluctance or at least, with much less reluctance.
After I’d commented on the cost of dues, she replied by asking, “But how much does a lawyer cost?” Then she said, “COA functions as our lawyers. It keeps our profession operating at the legislative level.”
I was quick to realize that lawyers are expensive, and that my dues payment was a bargain relative to legal bills. My optometrist friend was illustrating how our profession is a legislated profession: legislation can make us or break us, and the laws that define us are under constant adversarial pressure. In addition, it’s our responsibility to adapt and advance with the times both as a collective profession and as individuals, to continually increase the care we’re able to provide our patients. All of this has a monetary cost, and our collective dues make the endeavor affordable to us.
Our ability to organize as an Association gives us legitimacy in the eyes of politicians. The very existence of our ability to practice is based on state laws, and while we’re relatively powerless as individual optometrists, we have a strong voice as an organization.
There are countries in the world where optometry flourishes; there are other countries where it doesn’t even exist. It all depends on the laws in place and on our ability to make ourselves heard. As organized OD’s we are the COA.
With that being said, I wanted to give you all a brief outline of some of the membership benefits you may not be aware of:
- AOA and COA are constantly fighting legislative battles to protect our profession. These include initiatives to improve our reimbursements and prevent cuts in reimbursement, allow ODs to be included in certain federal incentive programs, and prevent discrimination of ODs on insurance panels.
- The recent successful passage of AB 443 has expanded our scope of practice. Additionally, last year, because of COA, California became the only state to allow TPA-certified OD’s to administer flu, shingles and pneumonia vaccinations.
- Think About Your Eyes is an exclusive public information marketing campaign offered by the AOA and available to COA members at a reduced fee.
- COA offers a free, continually-growing library of in-depth fact sheets addressing a wide variety of scope of practice and practice operation topics.
- The Member Media Center (MMC) through the COA website offers content for members to use in their newsletters and social media sites to help inform the public about important eye issues.
- COA has a Member Resource Center in which there are dedicated COA staff members who are available to answer common practice-related questions- from the steps to take to get on a health plan’s medical panel, to employment and workers’ compensation issues.
- Eyelearn is an online benefit exclusively offered to AOA members that is comprised of an easy-to-use centralized online learning resource with access to journal articles, webinars, practice management resources, etc.
- Business and Career Success webinars are offered by AOA with topics including medical records and coding, HIPAA updates, PQRS, malpractice, etc.
- COA provides constant updates on various topics with Government Affairs Weekly emails, California Optometry (the official publication of the COA), COA Member News monthly newsletter, AOA’s daily First Look and weekly AOA Focus e-newsletters, and the monthly AOA Focus magazine.
- Discounts on continuing education events including Monterey Symposium, OptoWest, and AOA’s Optometry’s Meeting.
- Opportunities for free continuing education (12 hours annually) through articles in California Optometry as well as further CE online through CE@HomeOnline
- Great deals as COA members from Vision West buying group. Insurance programs through Mercer Insurance, and exclusive discounts for members on professional liability, workers’ comp, cyber liability, etc.
- To ensure state and federal compliance with labor laws, COA provides discounted subscriptions for mandatory posters.
- As a COA member there is an opportunity to enroll staff as AOA and COA Paraoptometric Members at no charge to aid in enhancing the skills and productivity of your staff.
- AOAExcel’s Medical Record and Coding Services allows you to consult an expert with questions regarding accurate choices for procedure and diagnosis codes, changes in Medicare coding policies, ICD-10 preparation and conversion, and participation in PQRS through AskTheCodingExperts@ExcelOD.com
- As an AOA and COA member you are listed on each website under the Find An Eye Doc search portals to assist the public in finding an you.
- Optometry’s Career Center through AOA provides a great placement service for opportunities throughout the lifecycle of a practice.
- The Legal Service Resources Program provides members up to one-half hour (30 minutes) of telephone and research work per month with an attorney at no cost. The program offers services that will assist members in areas of the law related the practice of optometry including Licensure, Business Taxes, Regulatory and Contract Issues to name a few.
Please utilize these tools! Our membership fees provide us with plenty of great opportunities that we should all take full advantage of. Not only are we protecting our profession by being a member of AOA, COA, and SDCOS, but we also are empowering ourselves with access to resources that allow us to succeed on a daily basis.
Novel Pigmentary Maculopathy
By Nikolas J.S. London, MD FACS
Director of Clinical Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla
One of my favorite parts of my job is teaching. I love spending time explaining a disease like macular degeneration or how a retinal detachment occurs to my patients. Even better is having a higher-level discussion with other doctors. But, my favorite thing of all is when I learn something new from a patient or another physician. This happened recently when Dr. Earl Sandler sent me EM and this month I would like to share her case with you. This is a fascinating case of a new maculopathy only described for the first time a few months ago.
First the case. Patient EM is a 50 year-old Caucasian woman with no symptoms and 20/20 visual acuity. Dr. Sandler has followed her for several years, mostly for routine eye care, but on his last exam he noted the new appearance of pigment deposition in both maculas. She denied any symptoms, but the appearance was startling, so he sent her to us for evaluation. Amazingly, she made her own diagnosis, and brought an article in for me at our first visit. Most of the time I find these self-diagnoses to be incorrect, but in this case she appears to be right on the money.
On exam she was indeed 20/20 in both eyes with an IOP of 16 OU. Her anterior segment exam was unremarkable with clear lenses, no inflammation, and a clear vitreous. Fundus exam revealed an unusual pattern of macular pigmentation and atrophy of the retinal pigment epithelium (Figure 1). We obtained comprehensive imaging, which revealed irregular autofluorescence, mild macular edema OU on OCT, no abnormalities on OCT-angiography, mild leakage OU on fluorescein angiography, mild patchy decreased sensitivity on macular microperimetry, and abnormal dark adaptation time in her left eye.
The diagnosis. She denied any prior ocular history or any family history of vision issues or retinal disease. On past medical history, however, she described a long history of interstitial cystitis, a chronic condition characterized by bladder pain and urinary urgency. For this she was treated with peotosan polysulfate sodium (Emliron) for the past 10 years. This drug appears to be the culprit, and this association was reported in a recent case series published in Ophthalmology. In this case series the authors described 6 similar patients with negative genetic testing and all with good visual acuity. All had a diagnosis of interstitial cystitis treated with Emliron for at least 10 years and all had exam findings similar to our patient, patients with more longstanding disease developed RPE atrophy.
The causal relation between Emliron and the maculopathy is certainly not definitive, but seems very plausable. This would represent a novel and preventable toxicity that, unrecognized, appears likely to cause progressive damage to the retinal pigment epithelium and permanent loss of vison. We have a lot of great information about our patient, and I will be very interested to see what happens now that she has discontinued the medication.
Big thanks to Earl Sandler for sending me this fascinating patient.
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
A few years ago I received a note from an OD, that one of his patients had been murdered. Her glasses were found all bent up in a wastebasket.
In this case the police knew who prescribed the glasses and requested the doctor to send the records of the patient to them to verify that the glasses were hers.
She had been shot outside the home, . The husband claimed accidental shooting. Police theory was that she had been beaten up inside the home causing the glasses to be bent up. The husband was found guilty of the murder and sent to prison.
But, this was an easy case, since they knew who made the glasses.
What if they had no idea where they came from and the prescription was sent out to all optometrists within 100 miles. What are the chances that the Rx could be identified?
Up to now, , investigators and consulted eye professionals have been limited.
In another murder case, contact lenses came into the picture. In April, 2005, the victim was preparing for bed. According to the husband, he left the house to attend a soccer game, and when he came home he found her dead body. The husband was suspected, but with no concrete evidence to convict him, the case got cold. Years later a new detective noted that the victim’s contact lenses were not in its case, and family members reported to police that she always removed her lenses when going to sleep and put them in the case. The husband claimed she was wearing her glasses when he left.
Due to this discrepancy, the court ordered that the body be exhumed, to determine if the contact lenses were still in her eyes.
After inspection, the contact lenses were found to be still in the victim’s eyes, and a retrial was ordered in which the husband was found guilty of manslaughter and sentenced to up to 123 months in prison.
Because of the way we file, it is impossible to find the Rx in a data base. However, as record keeping becomes more computerized, it may become easier to find matches of prescriptions for identification.
Several studies have been done with somewhat limited success, and until more eye professionals set up a database in their practices of all the prescriptions of their patients, it’s next to impossible in many cases, to match them up with unknown individuals.
In my search for forensic optometry, there were also databases for children and the taking of Iris Photographs for identification.
Some optometrists have been testifying in courts about drivers who did not have their glasses on at the scene of an accident, and other DMV issues.
I recall having received letters from police departments with Rx’s to be identified with a patient name when glasses were found at the scene of a crime.
I’ve had glasses returned to me that were found in a glasses case with my name on it, and I recognized who the owner was. Once I even had a patient call me from jail (on a minor charge) asking me to arrange for bail. I asked her how she had my phone number. She said it was printed on the case. After that I stopped printing the phone number on my eyeglass cases.
It worked out ok, even though I bailed her out.
Any ideas on this???
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
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.
Optometrist Opening Part-time North County. Saturday 10 am to 3 pm, Wednesday 9 am to 6 pm. Interested candidates please send resume to firstname.lastname@example.org or call 760-930-9696. (02/19)
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 (02/19)
Urban Optiks Optometry is currently interviewing for a personable optometrist to join our professional team on a part-time basis (1-2 days per week). Qualifications would include: Must be able to work Saturdays, ability to fill in on additional days as needed a plus, strong diagnostic skills & a passion for delivering patient-centered primary eye care, team-oriented & willingness to chip in wherever necessary, familiarity with ExamWriter and Topcon CV5000 preferred. There is a great opportunity for an associate doctor to eventually acquire a partnership in our practice. For a chance to join this exciting team, please send resume & cover letter, including why you think you’d be a great fit to firstname.lastname@example.org (03/19)
Optometrist needed inside Mission Valley Costco on Tuesdays. Please contact Robyn Slikker, O.D. at (619) 977-7703 Cell or email@example.com (03/19)
Optometry Position in private practice in Clairemont, San Diego for 1 day per week (Fridays) Apply to firstname.lastname@example.org or call 858-560-5181 (03/19)
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. The 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 email@example.com (03/19)
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
ALL DOCTORS WILL RECEIVE A FREE 5 HOUR CE FOR EVERY SHIFT FOR WHICH THEY VOLUNTEER
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 Tuesday from 12-3!!
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
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!
- Simona Grosu
- Andrew Vo
- Joyce Lee
- Cheryl Duong
- Anna Rosales
Please update your information on www.eyehelp.org
Phone: 619 663 8439
Fax: 800 643 8301