The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Eye See
• CE Corner
• Get Free Glasses for Kids in Your Community
• Eye Care for Real Life
• Classifieds
• Volunteer Corner
• SDCOS Announcements

President’s Message November 2020

Dr. Wendy Gross

What a year this has been. From a global pandemic to protests for racial justice, devastating wildfires, and a tumultuous presidential election, our nation has found itself drawn into several crisis whose underlying causes threatened its health, economy, and forced every one of us to live in a world almost unrecognizable from what we’ve grown to expect.

As COVID-19 relentlessly spread across the country, we sheltered in place and businesses and public services small and large were forced to close. By the end of May, about a fifth of the nation’s workers were either unemployed or working part-time and millions of Americans found themselves without money to pay rent or even buy groceries to feed their families.

While the Optometric community has been hit hard by the events of 2020, I am proud to say that our local, state, and national organizations have not wavered in their support of our community. This pandemic has forced all of us to evaluate our priorities and compelled us to look at different ways of operating, many of which have brought new opportunities for growth and positive change that will help us to better serve our patients and the optometric industry in the years to come.

Serving as President of the San Diego County Optometric Society this year has been challenging, yet rewarding and I am so thankful to have had the privilege of holding this title during such a historical year. I would like to give a huge thank you to Nancy-Jo, our Administrative Director, and the Doctors in our society who have volunteered their time to make sure our society ran smoothly even through the difficult times. Shout out to our rock star 2020 Board Members for all their help this year: Drs. Robert Grazian, Alex Scovill, Simona Grosu, Roula El-Moghrabi, Amanda Dexter, Lucia Millet, Nickolet Boermans, Andrew Fasciani, Bob Meisel, Dave Sherman, David Ardakani, Dick Skay, Ilya Volk, John Fitzpatrick, Paul Lavin, and Michael Morgan. I also want to thank and acknowledge our trustees for 2020: Drs. Jenn Chinn, Kathryn Ordonez, Marcelline Ciuffreda, Nina Song, Tatyana Budarina, and Tiana Mathieson.

Before I pass the torch to Dr. Alex Scovill, who will be an incredible President for SDCOS next year, I want to welcome any doctors in our society to join the Board of Directors for 2021. It has been an incredibly rewarding experience being on the board, and I encourage anyone who is interested to reach out to me or any one of the wonderful doctors listed above for more information. New volunteers allow us to continue to bring new perspective and growth to our society and carry its traditions into the future.

While I am sorry to say there will be no in-person Holiday Party this year, please be on the look out for some of our upcoming virtual events and I hope to see all of you very soon. Thank you all for a great year. It has been my honor and pleasure to be the President for 2020. Happy Holidays!

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Retina Corner

By Nikolas J.S. London, MD FACS
President and Director of Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla

Hey everyone – I hope all are doing well. The day I am writing this we got the results of the presidential election with Joe Biden announced as the winner. Now, I know better than to make any political comments, I am sure we can all agree that we are happy that this is over. This year has been rough enough with a pandemic, and it is nice to have a very divisive election in the rearview mirror!

I thought this month we would go back to a case-based article, starting off with a short case description and question:

Karen is a 53-year-old Caucasian woman who presents with a 6-month history of “hundreds of floaters,” decreased vision, and nyctalopia. Examination confirms poor dark adaptation, moderate vitreous cell, mild disc edema, and cystoid macular edema. Her VA and IOP are normal. A photograph of the patient’s fundus is shown. Testing for which of the following human leukocyte antigens is most likely to prove informative? Also consider what the other ophthalmic diseases the other HLAs are associated with.

A: HLA B51

B: HLA A29

C: HLA B27

D: HLA B5

The correct answer is HLA-A29. The findings in this case are consistent with a diagnosis of birdshot chorioretinopathy (BSCR). BSCR is an idiopathic posterior uveitis that is more common in Caucasian women, and typically presents in the sixth decade of life. Early symptoms include floaters from mild vitritis as well as decreased vision from cystoid macular edema. Chronic disease is associated with nyctalopia and decreased color vision. The fundus photograph above is typical for the disease with numerous roughly 300 micron hypopigmented spots scattered throughout the fundus. Optical coherence tomography is important to document CME, and can be used to follow vitreous cell in the infrared image. Fluorescein angiography reveals the chorioretinitis with early hypofluorescence and late staining in the location of the spots, as well as optic nerve inflammation.  BSCR has a strong association with the human leukocyte antigen HLA-A29 (96% of patients are carriers). Patients can be managed with systemic corticosteroids (prednisone) once infectious etiologies are ruled out, but it is often preferable to treat locally with intravitreal corticosteroids such as Ozurdex. With good control, patients can do well for a very long time.

Figure. Color fundus photograph of a patient with BSCR revealing multiple hypopigmented spots. The SDOCT reveals no CME, but shows loss of detail in the ellipsoid zone of the outer retina as well as shadowing from vitreous opacities. Late frame fluorescein angiography reveals staining of the hypopigmented spots as well as leakage of both optic nerves.

Well, I think that is about it for this month. Thanks so much for reading. Please don’t hesitate to contact me with any questions.

On totally separate note, I have recently fell into the rabbit hole of collecting mechanical puzzles and have discovered some really incredible craftsmen who make ingenious puzzles. If there are any fellow puzzle nerds out there, let me know and I’d be happy to let you know the better designers out there and to share some of the puzzles I’ve collected.

Best wishes, and until next time,
Nik

Nikolas London, MD, FACS
Retina Consultants San Diego
london@rcsd.com

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Eye See written by Dr. Byron Y. Newman

An OD in Michigan, Joseph Johnson came up with a conversation between two contact lens fitter after seeing a similar idea about fishermen.  He came up with this back in the 1980s and I think you’ll get a kick out of it, if you can read it.

Here it is:  WHEN TWO CONTACT LENS FITTERS MEET

HI
GOODASEYA
HOWSYURPRAKTIS
CUDBEBEDDER
YUFITTINMANYCONTAKS
QUIDAFEW
METOOSUMTIMES
CHANESHURTINU
TAKALTHUEASYWUNS
WHABUFICALYAUSIN
NUNARANYGUD
HOWABOUTORICS
TRIDEMAL
USINHOTORCOLD
HOMADENHEETORSEPTICON
FITANYCOLORS
LIKARANBOW
WATSYURFAVRITLENZ
CHEEPASIKENBY
WELHANGINTHER

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

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Get Free Glasses for Kids in Your Community

As an eye doctor, you know how essential good vision is, especially for kids. It is estimated that 12 million children in the U.S. need vision care, and up to half are not getting it due to the barriers of awareness, access and affordability. Fortunately, charitable eye doctors around the country are stepping up to fill the gap and using Essilor Vision Foundation’s (EVF) Changing Life through Lenses® program to do so.

Changing Life through Lenses is a first-of-its-kind charitable solution that empowers philanthropic eye doctors and non-profits to help those in need. The program provides a free pair of glasses, including lenses, lab services and frames, when an OD donates a vision exam to a patient who is at or below the poverty level and does not have insurance for vision services. Changing Life through Lenses enables eye doctors and practices to give back in their own communities, whether they are currently engaged in charitable services or looking to get involved for the first time.

Kristin White, OD, practices in Northern California. “I was looking for ways to be involved in the community, and I came across Changing Life through Lenses in an online search for options to provide glasses for kids in schools,” she says. “We used the program at our kids’ vision events and it was extremely beneficial. The students we examined had failed their vision screenings with the school nurses, were at or below the poverty level, and their families were unable to take them to get an eye exam. Of the 155 students we examined, 123 needed glasses, which we were able to provide thanks to Changing Life through Lenses.”

Participating is easy

The Changing Life through Lenses website is easy to use and includes features such as:

• Real-time account creation – Registration takes less than five minutes. After creating an account, participants have immediate access to order frame to come, uncut or frame and lens products, along with all resources on the site.
• Complete pairs of glasses – The ability to order complete pairs of glasses (frame and lens) for qualifying patients at no cost.
• Dynamic routing – There is no lab assignment and orders are routed across multiple labs to increase efficiency in production of glasses.
• Lens selection – While lens selection is primarily single vision polycarbonate or flat-top 28 bifocals, special order process is available for other medically necessary lenses or treatments.
• Frame collection – Participants can order a free frame collection that includes 30 styles, most with alternate colors, giving patients 57 frame choices from eye size 42 to 58.

In light of the coronavirus pandemic, EVF is anticipating there will be even more families who may need financial assistance to get vision care. Join the more than 2,000 eye doctors who are already using Changing Life through Lenses to make a difference in their communities. Learn more about how you can help at changinglifethroughlenses.org.

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Eye Care for Real Life ProDHA Eye specifically formulated to protect eyes from ultraviolet blue light.*

Healthy vision depends on omega-3s over decades of sight, eye strain, and artificial light. It’s no surprise that the eye has the body’s highest levels of omega-3 DHA.

Nordic Naturals ProDHA Eye® is an investment in lifelong eyesight with its unique blend of concentrated DHA to support retinal and macular health, plus lutein and zeaxanthin to help the eye address harmful blue light.*

Order Now

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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!

This webinar qualifies as “live” CE for CA licensing requirements
Speakers: Stacy Hu
Topic: Ocular Inflammatory Manifestations of Systemic Diseases
Date: November 19th, 2020
Webinar ID: 823 4841 2067
Passcode: SDCOSCE

Free for SDCOS members
$35 for COA/AOA Members
$130 for Non-members
Free for Students
Free for Sponsors

To Join the Webinar
Join from a PC, Mac, iPad, iPhone, or Android device:

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Participants must be signed into the virtual meeting for the full presentation time to receive a certificate. If this is your first time using Zoom and you are having difficulty with log-in, please feel to contact our administrative director, Nancy-Jo, at sdcos@sdcos.org  for assistance.

See 2020 CE schedule

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COA Monterey Symposium November 7-8, 2020

10 hours of CE – including four hours of glaucoma CE with virtual exhibit hall and networking.

Speakers and Topics:

Marc Bloomenstein, OD, FAAO – Anterior Segment Case Challenges
Paul Karpecki, OD, FAAO Think outside the Box – What’s New in Optometry Part I – Think Outside the Box – What’s New in Optometry Part II.
Sarah Kochik, OD, PhD, FAAO – Atropine for Myopia Management
Robert Wooldridge, OD, FAAO – Controversies and Consensus in Glaucoma – Decisions in the Medical Management of Glaucoma.

https://sites.google.com/coaboard.org/coace/monterey?authuser=0

COA members – $20
Non-members – $99
Student members – free

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Classifieds

Practice for Sale: North County “Carlsbad” upscale high-end practice. Owner at the same location over 30 years, boasts a strong net with easy hours. Great visibility location within high traffic Vons Center, theatres, library, great restaurants, great tenant mix. Office current remodeled with glass showcases, LED lighting, granite countertops, designer wallpaper, light wood floors. Updated equipment in the exam and pretest room with blue tooth transfer. Great opportunity to own a modern practice and be independent with much room for continued practice growth. Call Howard Levy, OD 760-310-8492 or email bluesdoch@yahoo.com PRICED TO SELL! (11/20)

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Volunteer Corner

Monarch School Screening

Contact Dr. Bob Meisel for more information at rmeisel47@gmail.com ; www.monarchschools.org

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Lion’s Optometric Vision Clinic

ALL DOCTORS WILL RECEIVE A FREE 5 HOUR CE FOR EVERY SHIFT FOR WHICH THEY VOLUNTEER

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.

The LOVC has Reopened!!

Please call or email the clinic if you are interested in volunteering:

• 619.298.5273
• lionsvisionclinic@gmail.com

Alterations to the schedule to accommodate social distancing are in place and PPE will be provided for all volunteers/staff/patients.

New flooring was installed with the donation from the SDCOS 2019 golf tournament and a special thanks to Dr. Phil Smith!

Please think of the LOVC for your end of year charitable giving, visit our website:  lionsvisionclinic.org

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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 the society office at 619-663-8439 or email sdcos@sdcos.org

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SDCOS Announcements

SDCOS was on NBC 7! click here to see the clip

• Click here for most recent SDCOS Board Meeting Minutes
• Click here for the 2020 CE schedule!
• Click here for COA membership benefits!

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Welcome, new members!!

• Melissa Willey

Please update your information on www.eyehelp.org