The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Eye See
• CE Corner
• Classifieds
• Volunteer Corner
• SDCOS Announcements

President’s Message October 2021

By Alexandra Scovill

I am going to use this month’s President’s Message to give another COVID update. Unfortunately, we had to cancel our in-person CE last month due to an increase in cases of COVID in San Diego. There have been about 14,000 new cases in the last two weeks (or 1,000 new cases per day) compared to about 50 new cases per day back in July. There is speculation as to the cause. Is it the new Delta variant that seems to be more contagious, even in vaccinated individuals? Is it the unvaccinated who are spreading the virus? Or is it waning immunity from the vaccine?

Studies have shown that vaccinated individuals can spread the virus just as easily as unvaccinated individuals. Those of us who are vaccinated carry the same viral load of the Delta variant in our nasal passages as unvaccinated.  This means we can spread it just as easily, but we likely will not get as sick. This is why the CDC recommends still wearing a mask indoors even if you are vaccinated. In addition, new reports are showing that 98% of the hospitalizations from COVID, in the recent months, are people who are not vaccinated. This shows us that the vaccine is indeed working and why it is so important to get vaccinated! Although, there are cases of vaccinated individuals being hospitalized. This brings me to my next point: who gets a booster vaccine and when can they get it?

The last update from the San Diego County Health and Human Services Agency reported that only those who received two doses of Pfizer are eligible for a third dose at this time. Those who received Moderna or Johnson and Johnson are not eligible, but more research is being done to determine if it will be needed in the future. The CDC and CDPH recommend the following groups should get a third dose:

• People 65 years and older
• People aged 18 years and older in long-term care settings
• People aged 50-64 years with underlying medical conditions

The CDC and CDPH recommend the following groups may receive a third dose:

• People aged 18-49 years with underlying medical conditions
• People aged 18-64 years at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting:
  • First responders (healthcare workers, firefighters, police)
  • Education staff
  • Corrections workers
  • U.S. Postal Service workers
  • Grocery store workers

So, as a healthcare worker, you may receive a third dose if you have received two doses of Pfizer already. The third dose can be administered any time 28 days after your second dose of Pfizer, no sooner.

If you would also like to receive the newsletters or telebriefing invitations from the San Diego County Health and Human Services Agency, you can register here: registration link.

I hope you are all staying safe and I hope to see you soon!

---

---

Retina Corner Gene Therapy

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

Dear SDCOS,

Hopefully everyone is doing well. Fall is here, and I don’t know about you, but I love the cool crisp air, and beautifully sunny fall days. It’s an amazing time of year.

Just a few weeks ago, I had a huge honor of being inducted into an honor society in our field – the Retina Society. We had a wonderful conference in Chicago, and I was incredibly privileged to present the first ever data on our study looking at gene therapy for neovascular macular degeneration – the AAVIATE study from REGENXBIO. I didn’t realize it at the time, but it was a very big deal, with thousands watching, and a major press conference following my talk. Straight from the cutting room floor, I thought it was be fun to share the highlights of the talk with you this month. Gene therapy is an unbelieveable technology, and I am so very excited for what is in store for our patients.

Study Design and Safety Update from Phase II AAVIATE Trial of RGX-314 for the Treatment of Wet AMD Using Suprachoroidal Delivery

AAVIATE is a randomized, active-controlled, dose-escalation trial that is evaluating the efficacy, safety and tolerability of RGX-314 delivered via a small needle into the suprachoroidal space in an in-office procedure. Twenty patients in Cohort 1 were randomized to receive RGX-314 at a dose level of 2.5×1011 genomic copies per eye (GC/eye) versus monthly 0.5 mg ranibizumab. Cohorts two and three looked at a doubling of this does. Patients in all three cohorts did not receive prophylactic corticosteroid therapy before or after administration of RGX-314. These three cohorts have fully enrolled, and we have started to enroll the final two cohorts, receiving another double dose of 1.0×1012 GC. So far, RGX-314 has been reported to be well tolerated across 50 patients dosed in Cohorts 1-3. Four serious adverse events were reported in four patients, all of which were considered not related to RGX-314.

Summary of Data for Cohort 1 at Six Months

Fourteen patients dosed with RGX-314 in Cohort 1 demonstrated stable visual acuity at six months with a mean best corrected visual acuity change of -0.6 letters from Week 1. These patients also demonstrated stable central retinal thickness (CRT), with a mean change of -2.5 µm at six months from Day 1. Five patients receiving monthly injections of ranibizumab had a mean BCVA change at six months of +3.0 letters measured from Week 1. Patients receiving monthly injections of ranibizumab also demonstrated stable CRT, with a mean change of -22.2 µm at six months from Day 1.

There was a very meaningful reduction in anti-vascular endothelial growth factor (anti-VEGF) treatment burden in patients following administration of RGX-314 compared to the mean annualized injection rate during the 12 months prior to administration. Patients in Cohort 1 received a mean of 1.2 injections over six months following administration of RGX-314, which represents a 76% reduction in anti-VEGF treatment burden. Four out of fourteen patients received no anti-VEGF injections over six months following RGX-314 administration.

Side effects in the study eye were generally mild, and none were severe. These included conjunctival hemorrhage, worsening of wet AMD, conjunctival hyperemia, and dry eye. In addition, mild intraocular inflammation was observed in four out of 15 patients based on slit-lamp examination. All cases were resolved within days to weeks on topical corticosteroids, which have been discontinued.

These results are very early, but are extremely exciting. This therapy brings gene therapy into the office, as opposed to the operating room, both phakic and pseudophakic patients are being treated, the reduction in the number of injections is impressive, and the safety profile looks outstanding. While it is too early to go all in on the treatment, I am very excited for our patients. They may not have to deal with a lifetime of intravitreal injections for their wet AMD after all.

Thanks again for reading. Please don’t ever hesitate to contact me.
Best wishes, and until next time,
Nik

Nikolas London, MD, FACS
Retina Consultants San Diego
Poway, La Jolla, Carlsbad, Hillcrest, and Coronado
415-341-5456 (cell)
nik.london@gmail.com

---

---

Eye See written by Dr. Byron Y. Newman INTERVIEWING JOB APPLICANTS

Some optometrists interview job applicants and are pretty sure the applicant will work out ok for their practice. Some are stunned when their selection turns into a dud. One reason is, according to a management magazine, that it is becoming more difficult to identify the best applicant is the increased effort spent to prepare job seekers for their employment interviews. For a fee, some companies groom job applicants in the finer points of making favorable impressions.

With all this effort at making the aspiring employee a master of the recruitment process, it’s not surprising that one could end up hiring an accomplished actress rather than a competent worker.

Some tips they offer include getting the applicant relaxed and make him or her really talk instead of answering questions. You want to find out the real personality inside the body sitting across from you and break down artificial defenses. Be familiar. Encourage the interviewee to call you by your first name, and to have a cup of coffee or tea. The sooner you make the candidate believe they’re acceptable the better chance that they will spend less time projecting. And most important of all, let the applicant talk freely.

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

---

---

---

CE Corner We are committed to helping you fulfill your CE requirements through our local virtual meetings with the support of our sponsors!

Featured Annual Sponsors

2 Hour Virtual CE: Thursday December 2, 2021
Topic and Speaker TBA

• See 2021 CE schedule

---

COA events

Other upcoming COA event dates:

• October 18th

Check out the COA website for more info: www.coavision.org

---

Classifieds

CLASSIFIED ADVERTISEMENTS

Exceptional Eye Care San Diego, CA AT OUR OPTOMETRY OFFICE, we are a diverse staff with unique specializations. We are looking for a caring & qualified optometrist to join our team. OD & CA optometry license required. We are looking for an OD with EXCELLENT communication skills. We are offering competitive salaries, modern medical equipment in a private practice setting. Please send current resume and availability to Valerie Vasquez by email at valvasquez282@gmail.com (09/21).

Practice for Sale: This well-established practice is located in North San Diego County in a new retail building. Steady annual gross revenue with strong net profit. The current owner focuses on medical eye services and general optometry. Revamp the optical dispensary, increase marketing and watch this practice reach new heights! All ophthalmic equipment, transition assistance are included in the sale. Long-term lease, 1500 square ft., large optical space, 2 exam lanes, 1 pretest room, 1 contact lens room, 1 waiting room, 1 dispensing room, 1 Dr.’s office, & 1 storage room. For further inquiries Contact John americaneyeglasses@gmail.com (09/21).

Part-time optometrist needed for optometry office in Chula Vista.   The doctor will be working with excellent support staff who provide full work-up. Come and join our great team!  Please email CV or questions to emascareno@yahoo.com or call Dr. Mascareno at 619-254-0115 (11/21).

Kimberly P. Cockerham, MD, FACS has joined Senta Clinic in Mission Valley. She is a board-certified ophthalmologist with dual fellowship training and two decades of experience in neuro-ophthalmology, orbital disease, and oculofacial reconstruction. Career milestones: BA in Biology, UCSD Revelle College; US Army scholarship to George Washington University Medical School (graduated AOA); General Surgery Internship at Letterman Army Medical Center; Ophthalmology Residency -Medical Neuro-Ophthalmology Fellowship at Walter Reed Army Medical Center; Surgical Neuro-Ophthalmology, Orbit and Oculoplastics Fellowship at Allegheny General Hospital, Pittsburgh, Pennsylvania; Chief of Oculoplastics/Orbital Disease/Surgical Neuro-ophthalmology at Walter Reed Army Medical Center (earned  National Defense Service Medal, Superior Unit Awards, Commendation Medal, and Meritorious Service Medal); Director of Oculoplastics and Orbital Disease and Consultant, Neuro-ophthalmology at UCSF; In Private practice and Adjunct Clinical Associate Professor, Department of Ophthalmology, Stanford School of Medicine since 2006. “I look forward to working together, text or call me anytime. Kind regards, Kim” O: 619-810-1111 C: 650-804-9270  KCockerham@Sentaclinic.com SentaClinic.com CockerhamMD.com (10/21).

Practice for sale: Long-time established practice for sale in La Mesa–seller wishes to retire–Seller has set a very low purchase price to facilitate an immediate sale—don’t miss out on this great opportunity to own your own practice.  Contact Dr. Levy at 619-743-1442 or email at drlevy@pacbell.net (10/21).

Turnkey practice is available in Murrieta, California. The last 12 months gross is $480K with a net of $165K. It has modern equipment including a digital exam lane, iCare Tonometer, and Optos Daytona. The optical is bright and modern with around 600 frames. The current gross is on 37 doctor hours during the week and no weekend hours at this time. Located near the vineyards, this area has some of the most affordable housing costs in Southern California with fantastic schools and is less than an hour from the beach and mountains. Asking for $225K OBO, plus inventory.  Willing to negotiate for a quick sale! Contact murrietaoptometryforsale@gmail.com for more info. (10/21).

Part-Time OD wanted: In search of an optometrist for 1-2 days a week as an employed OD of a Target Optical sublease. Extremely clean, organized, and high-tech office where we are laid back and have fun helping patients with full-scope optometry needs. Ideal candidates would be friendly, outgoing, business-minded, and available starting mid/late September. Competitive daily rate and other bonuses available. Email drkellykeane@gmail.com if interested. (10/21).

Part-Time Optometrist Wanted. 2-3 days per week. Must be available some Fridays and Saturdays. Please email drmarbun@gmail.com (11/21).

Doctor retiring after 45 years of continuous practice in a prime location one block from the ocean in the affluent community of Solana Beach CA (N. Sand Diego County).. Beautiful high-end dispensary, up to 3 exam lanes, separate dispensing area, and in-house finishing lab. Lease option in place. Medical billing and co-management of Lasik and cataracts in place for years. The office noted for highly personal care, community involvement, and high technology. This is a great opportunity to purchase a well-established practice for much less than opening up cold. If desired, the doctor would be willing to stay part-time for patient retention and transfer to the new owner. Contact: Michael Foyle OD mfoyleod@yahoo.com 858-353-0600. (11/21).

Maternity leave coverage from January to March. Full time, Monday-Friday, 8-5 with a 1-hour lunch break. The position is in the optical department of Castillejos Eye Institute in Chula Vista. Please contact Olga Ramirez, at castillejoseyeinstitute@hotmail.com (11/21).

Associate Optometrist (4-5 days a week) Urban Optiks Optometry is currently interviewing for a friendly and energetic optometrist to join our professional team. Our digital, tech-centric practice & upscale optical boutique showcases one of the finest collections of luxury eyewear in San Diego. With a reputation for providing exemplary personalized customer service, along with the finest products and latest lens technology, Urban Optiks provides an unparalleled optical experience. Learn more about us at www.uoosd.com Qualities that make the ideal candidate stand out: • Experience in a high-end independent practice with a focus on providing quality, individualized routine eyecare • Strong communication skills with an ability to build patient trust and confidence in order to facilitate premium product sales • Excellent refractive & diagnostic skills • Proficiency with contact lenses and dry eye evaluation & treatment • Familiarity with OfficeMate/ExamWriter, Topcon CV5000 refraction system, Topcon CA-800 corneal analyzer, and Topcon Maestro 2 retinal imaging device. This is a salaried position with bonus incentives, medical benefits, and paid time off (vacation) after 90 days. The position will start off at 4 days a week with the potential for a 5th day based on business growth. If you are a motivated individual with a passion for delivering a superb patient experience in an unhurried boutique environment, please email your cover letter and resume to hr@uoosd.com  (11/21).

FT Optometry position; opening in North County, San Diego. The candidate should have knowledge in Cataract/Refractive surgery pre and post-operative care.  The candidate should be familiar with all refractive surgery modalities and premium IOL’s.  Optometric residency in refractive, medical, or primary care is preferred but not required. Requires CA license and TPA certification. Salary based upon experience. Please email CV to eyefixeyz@gmail.com (10/21).

PT Optometrist: Optometrist needed for premier growing refractive eye center located in San Diego. Most important qualifications are a good personality in order to exceed patient expectations and exhibit a willingness to learn. This opportunity is a fast-based environment at a beautiful office and convenient location.  Please email a cover letter with resume to Dr. Schiff at eyeschiff@aol.com (10/21).

---

Volunteer Corner

Monarch School Screening

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

---

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.

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

---

DONATE GLASSES
Please contact the society office at 619-663-8439.

---

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

---

SDCOS Announcements

For updated information and resources regarding COVID in San Diego, please register using this link. This will sign you up to receive weekly emails from the San Diego Health and Human Services Agency, including weekly tele-briefings on everything COVID.

• Click here for most recent SDCOS Board Meeting Minutes
• Click here for the 2021 CE schedule!
• Click here for COA membership benefits!

---

Welcome, new members!!

• William Schiff

Please update your information on www.eyehelp.org