The San Diego View

Inside this Issue:

• President’s Message
• Retina Corner
• Eye See
• 4 Ways to Optimize Your Website for Mobile
• CE Corner
• Classifieds
• Volunteer Corner
• SDCOS Announcements

President’s Message November 2021

By Alexandra Scovill

We are coming to the end of 2021, and looking back it was another rollercoaster of a year! From COVID-19 vaccines becoming available and life starting to resemble normalcy, to the Delta variant bringing doubt about our public safety again. Although we were entirely virtual this year, we were still able to accomplish a lot! We had numerous virtual CE’s with nationally renowned speakers and we treated our homeless veterans at Veteran Standowns. We also were able to meet virtually with legislators in Sacramento to discuss the importance of optometrists being able to administer COVID-19 vaccines, expanding our scope of therapeutic medications available, and giving new graduates the opportunity to begin working under a licensed optometrist while they wait for their license to be processed during a pandemic. All these accomplishments are why I am a proud member of SDCOS. Together we are making our city, and state, a better place for all.

It has been a challenging year as president, trying to steer our society through an uncertain time. Although it looks like we will not be able to have an in-person CE this year, we are planning on a few in-person CE’s next year! In addition, we will be hosting our Annual Holiday Party on December 18th! This affair will be the perfect entrance back to live events! It will be held at Stone Brewing in Liberty Station, which is an outdoor venue, and the theme is Mask-erade! Creative, decorative masks are encouraged! I hope it will be a fun, as well as safe, celebration as we are finally able to get together again after nearly 2 years apart! We look forward to seeing you there! Keep an “eye” out for ticket sales!

Of course, none of this would have been possible without the help of our amazing board and Administrative Director, Nancy-Jo! It has been a dream working with this excellent team! I would like to thank everyone on the board for their hard work, making this year run smoothly! I would like to especially thank Nancy-Jo, she is the back-bone of this society and we would be lost without her. I have really enjoyed my time as president, although I had to make many tough decisions, I feel rewarded knowing that our society is still thriving as we near the end of the pandemic. However, there are still many tough decisions to make, so if you would like a voice in how your society will look in the following years, I would encourage you to volunteer a little of your time and join the board!

And finally, thank you for the opportunity to serve you as President this past year! I am looking forward to what 2022 has in store! Cheers!

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

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Retina Corner Wet AMD and the Upcoming NKOTB

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

Happy Holidays, everyone! We are well into November, and I absolutely love this time of year. It is packed with wonderful family events for the London clan – Halloween and Thanksgiving are appetizers for Christmas in December, our annual trip to a Wilco music festival in Mexico in January, and our family ski trip to Steamboat Springs in February. It’s fun to have something every month to get excited about. Speaking of things to look forward to, I am very excited about one of the new medications on the brink of FDA approval for wet AMD, faricimab from Genentech.

Genentech is the same pharmaceutical company that brought us Lucentis in the early 2000s – the first effective FDA treatment option for wet AMD, and has been working hard on developing and evaluating new molecules ever since. This has culminated in faricimab, which capitalizes on the strong efficacy of our current anti-VEGF injections, but combining anti-VEGF and anti-Ang-2 activity into a single molecule. We will discuss the benefit of this new anti-Ang-2 activity shortly, but first I wanted to provide some background regarding why this is important.

Despite tremendous achievement with current anti-VEGF (vascular endothelial growth factor) options, there are still pathologic mechanisms that are not fully addressed, including vascular leakage and inflammation, which may explain some of our non-responders, exacerbate scar formation, and reduce long-term vision outcomes. This may explain the eventual decline in visual acuity in some long-term studies of anti-VEGF monotherapy.

In addition to VEGF, the angiopoietin pathway plays an important role in vascular stability and homeostasis, and dysregulation is involved in wet AMD. In brief, angiopoietin-1 (Ang-1) promotes stability – it is released from platelets and pericytes, and activates Tie2 receptors on endothelial cells. This leads to tightening of endothelial cell tight junctions and recruitment of pericytes, which wrap around mature vessels. Both of these result in maintenance of vascular stability. Ang-2, on the other hand, disrupts this process. If Ang-1 is the bouncer for a nightclub, Ang-2 is the drunk guy that bum rushes the door. Ang-2 blocks Ang-1 from interacting with the Tie2 receptor. This prevents all of the protective mechanisms of Ang-1, leading to vascular leakage form weakening of endothelial tight junctions, vascular destabilization from pericyte loss, and eventually vascular sprouting, neovascularization, and fibronectin deposition, which may promote scar formation.

This leads us to faricimab which, again, is a single molecule that provides dual inhibition of VEGF and Ang-2. Over the past several years faricimab has been evaluated in multiple clinical trials, including the recent phase 3 trials, TENAYA and LUCERNE that we were lucky to participate in. In these studies faricimab was studied in about 700 patients with wet AMD, and was shown to excellent visual acuity outcomes, with substantially better durability compared to aflibercept (Eylea), which is the most frequently-used current anti-VEGF treatment. Nearly half of patients were successfully extended to receiving treatment every 4 months, compared to every 2 months which is about average for patients in the real world. TENAYA and LUCERNE are almost wrapped up, and the data is being evaluated in preparation for submission to the FDA. Hopefully this means that we will have the drug in our clinics soon, and available to our patients to improve their visual outcomes and minimize their need to see me!

Well, thanks for all who got through that. Apologies if it was a bit dense. Thanks again for reading and 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

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Eye See written by Dr. Byron Y. Newman ANIMAL OPTOMETRY

Some years ago I was asked to aid a middle school student with her science project. She had read somewhere that a rat on a diet of just yogurt would develop cataracts, and she wished to check it out.

So, she got 3 white rats and fed one a diet of regular rat food, one with a diet of half rat food and half yogurt, and one nothing but yogurt.

At a time determined to be correct, she brought them into me to check them out. So, with my trusty ophthalmoscope I attempted to peer into the eyes of the little rascals (they were more interested in nipping at my nose) and finally did determine that the rat fed only yogurt had developing cataracts, as the student had expected. The student won the top prize at the science fair and I got my picture taken with the rats.

Through the years I was occasionally called upon to diagnose conditions of pets owned by my friends and relatives, and now I discover that I missed a golden opportunity to learn more about this subject. Lo and behold I found out that at an upcoming convention in New England, there was a course being offered by a veterinarian titled “Ocular Care of Domestic Animals.”

It was defined as a lecture that will introduce optometrists to the common ocular problems encountered in animals such as cats, dogs, horses and cows.

Rats weren’t mentioned.

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

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4 Ways to Optimize Your Website for Mobile

Why optimizing your site for Mobile is no longer a recommendation but a requirement

Starting in March of this year, Google declared open season on desktop websites. As the de facto ruler of internet search, they decreed that the only websites worth ranking are mobile sites. This means Google has started judging all web content based on how it looks and functions on mobile devices. If your website doesn’t work well on mobile devices, or if you’re still designing your websites for desktop and don’t have a mobile-specific version of your site, get used to empty waiting rooms because none of your patients will be able to find your practice online.

Google has decided to give everyone an ultimatum: Either make your website mobile-first, or you can kiss all organic traffic goodbye. As John Mueller, Google’s Webmaster Trends Analyst said “We will drop everything that’s only on the desktop site. We will essentially ignore that.”

Living in a Mobile World

As the popularity of smartphones and tablets have increased, so has the use of mobile search. In a previous article, we discussed that the vast majority of optometry searches are performed using mobile devices. This is especially important when you factor in that a good chunk of these searches are done while someone is driving around looking for a particular service in their area.

So let’s be real for a second. While Google’s heavy-handed approach to forcing mobile optimization is a powerful motivator, optimizing your websites for mobile search is just good business. The best way to attract patients is to meet them where they are, and your patients are increasingly on mobile-based platforms.

Welcome to EyeCarePro’s Mobile Optimization Boot Camp

1. Simple Designs = Lower Bounce Rates

Attention spans are short. Anything that distracts from the main reason a user chose to visit your site is a great way to frustrate them into seeking answers elsewhere. A streamlined design can help keep your bounce rates low and your engagement high.

There’s a couple things you need to keep in mind when designing a mobile friendly page: Screen size and above-the-fold content.

Mobile devices have smaller screens than desktops. They also have different dimensions, leading to different page margins and lengths. When content designed for desktop is pushed to mobile devices, page elements tend to shift around a lot. This can be very bad if design elements end up either out of order or overlapping each other.

This also impacts above-the-fold content. Above-the-fold is a term used by web developers to describe the area of a web page a user sees before scrolling. It’s essentially your chance to make a great first impression. Ideally, this is where you would put the page’s most important information so users see it immediately. If users can’t find what they’re looking for right away, they usually don’t stick around.

To solve both of these design issues, you’ll want to switch over to mobile templates using responsive designs. A responsive design automatically adjusts the sizing and positioning of your page components to match the user’s device. This makes it far less likely that potential patients will bounce from your site, and far more likely that they’ll stick around to hear what you have to say.

2. Clamp Down on Pop Ups

We’ve all been there. You’re minding your own business, reading an interesting article when suddenly, the content darkens and an obnoxious overlay seizes your entire screen, asking you to subscribe or buy something.

Getting a sudden, unwanted, intrusive sales pitch can make website visitors feel like they’re being ambushed, and in many cases, causes users to bounce. But higher bounce rates aren’t the only damage they cause. Pop ups slow down page load speeds, which is another key component of mobile optimization (see below). Additionally, interstitial pop ups have been part of Google’s rogues gallery of bad SEO practices since 2017. If you’re still using them, chances are you’re sabotaging your search rankings.

It’s in your best interest to ditch pop ups. Instead, try building the content into your page as a static element in an unobtrusive way.

3. Get Fast, or Be Furious

In our previous post on DIY web traffic strategies, we discussed how another of Google’s recent search ranking factor changes, Core Web Vitals, made waves. Faster loading pages rank higher now. And when Google has admitted that even a one second delay in load time can drop conversions by 20 percent, there’s more than one reason to want your pages to load at warp speed.

First, you’ll want to diagnose the problem. Head on over to Google’s Page Speed Insights and enter your URL to get an idea of what kinds of problems your site is facing.

Some of the more common problems involve images and third-party plugins on your website. To deal with images, either compress them or set up your page to lazy load images as a user scrolls instead of all at once at the beginning. Third-party plugins are a bit trickier. Page Speed Insights can point you in the right direction if there’s a problem, but you’ll have to troubleshoot the plugins yourself.

Another good practice is to enable HTTP caching on your site. This allows a user’s browser to save vital details about the page, creating a shortcut that allows them to load the page even faster on all subsequent visits to your site.

Finally, avoid video and animations if it can be helped. GIFs and videos take a long time to load and slow down pages considerably. If you need to use a video, do NOT use a video player to do it. Embed the video file directly onto your site.

4. There’s No Substitute for Good Ol’ QA Testing

If you do nothing else, you should at the very least get in the habit of testing your content before it goes out. It costs nothing, takes very little effort and can be done in a few moments.

Most content platforms will have a function where you can view a webpage as different devices. Always make sure to test your content on a smartphone, tablet and desktop computer before making it live. This allows you to spot mistakes the responsive page may not have compensated for, and adjust accordingly.

Mobile optimization really comes down to user experience, so the more things you can do to make answering a user’s search query quick and intuitive, the better.

Need Help Going Mobile?

If you’re looking for a beautifully crafted, mobile-first optometry website, EyeCarePro has just what you need. But we won’t stop there. Our goal is to help your practice get more patients. That’s why we offer web content designed to get traffic to your site and professional SEO to help your site get the visibility it deserves and pull in the new patients you need.

We do it all, from creation to maintenance. We’ll even host your website for you so you can devote your entire attention to your practice and patients.

Give us a call at 888.737.5494 today, and let’s mobilize your website!

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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
Speaker: Brooke Messer, OD, FAAO, FSLS
Topic: Myopia Control
Zoom Link
Web ID: 852 4294 0484
Webinar passcode: 569428

• See 2021 CE schedule

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Classifieds

CLASSIFIED ADVERTISEMENTS

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).

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 (11/21).

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. (11/21).

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. San 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).

OPTOMETRY PRACTICE FOR SALE: Coastal San Diego County, CA This modern practice has been established for just over 5 years and is located in an affluent area of coastal San Diego County.  Situated on a busy main street in town in a mixed-use commercial/residential building on the ground level with high visibility, the practice is beautifully designed and truly turnkey. Purchase includes 2 exam rooms, pre-test area, spacious dispensary, lab, frame inventory and EMR.  Annual revenue is almost $300K on part-time doctor hours with plenty of room for growth.  Seller is motivated and willing to assist in transition.  Please contact Allison Robles at Practice Concepts at 714-797-1605 or email allison@practiceconcepts.com for more info. (ID#76720) (12/21).

Fill-in Optometrist needed: looking for coverage on 12/22/2021, 12/23/2021, and 12/26/2021 in my sublease in National City. Offering a $250 bonus per day in addition to $450 per diem. Modern office with digital refraction, EHR, optos, and pretesters. Please contact Dena at 651-808-0247 or denashahani@gmail.com (12/21)

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Volunteer Corner

Monarch School Screening

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

Monarch School Screening Returns!

After 21 months of delay due to the pandemic, the semi-annual SDCOS vision screening resumed at the Monarch School for homeless students in early November.

Dr. Tiana Mathieson joined Dr. Dick Skay, a faithful volunteer for many years, and Dr. Bob Meisel, event coordinator for several years and 3 members of UCSD pre-optometry club to complete the screening of all K-12 students started by Dr. Beverly Bianes and her staff in October.

All of the referred students will be examined for prescriptions and given eyewear before the end of the year.

The spring semester will feature the VSP Mobile Clinic returning to SD after a pandemic pause, allowing for student exams and fabrication of the glasses on-site

The California Lions Friends In Sight program provides recycled eyewear and eye health screenings at various locations throughout CA, with at least one event each month…

Recently two events were held in San Diego county and the SDCOS was represented by Dr. Bob Meisel, Director of Public Awareness.

Vista Boys and Girls Club hosted the August screening with SDCOS Vista member Glen Demlinger, OD and Dr. Frank Scotti, ophthalmologist from Encinitas joining the volunteer team along with several Western College of Optometry students

In November, the Mountain View Community Church in Ramona was the host site Dr. Susan Cervantes and Dr. Susan Homesley, who both practice in Ramona, joined an even larger team of eye care volunteers.

Six optometry students from MBKU along with faculty member Corina Van De Pol, OD, who was also present in Vista, were very valuable as clinicians.

Events in San Diego county in 2022 are scheduled for Chula Vista in July and San Ysidro in September

www.clfis.info to learn more

 

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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

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

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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

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!

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Welcome, new members!!

• Pavit Basi
• Sonya Hooks-Broyles
• Marlon Mendoza
• Coral St. Onge

Please update your information on www.eyehelp.org