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
By Simona Grosu
Healthy Vision Month is celebrated every year in May to stress the importance of the health of our eyes. This month was established by the National Eye Institute in 2003 and aims to spread awareness and educate people about the risks of ignoring the health of their eyes.
Promoting the importance of healthy vision and regular eye examinations is a daily undertaking for doctors of optometry, but it’s a message that’s especially strong in May.
Here are just a few interesting historical facts about the eye.
The first record of the treatment of eye disease dates back to the Ebers Papyrus from Egypt in 1550 B.C. Another early medical text that had extensive info about eye treatment was the “Sushruta Samhita,” an ancient Sanskrit text on medicine and surgery that is considered one of the pillars of Ayurveda, dating back to the 6th century B.C. The Ancient Greeks also made key advances in the understanding of the human eye. The Middle Ages saw the use of the microscopes and lenses to examine the eye and its structure.
In the early 1800, Georg Joseph Beer, an Austrian ophthalmologist, is credited with introducing a flap operation for treatment of cataracts, as well as popularizing the instrument used to perform the surgery. In 1931, Vladimir Petrovich Filatov became the first person to perform a successful corneal transplant. Charles Schepens founded the Retina Foundation in 1950 (now known as Schepens Eye Research Institute). Ioannis Pallikaris, a Greek surgeon, performed the first Lasik surgery in 1989.
All this proves how steady research was in the field of the treatment of the human eye. And more remains to be discovered. According to a survey conducted by the National Eye Institute, more than 23 million Americans aged 18 and above have never undergone an eye exam. And the reason is that most think they don’t have an eye problem. This attitude can have consequences in the future. Surveys further suggest that by 2030, approximately 4.2 million people will have glaucoma, 11.5 million will have diabetic retinopathy, and 2.8 million will have age-related macular degeneration.
In support of Healthy Vision Month in May, the American Optometric Association is encouraging everyone to take charge of their eye health and preserve their sight by following some simple tips. Here are just a few:
- Get regular dilated eye examinations from an eye care professional
- Live a healthy lifestyle by maintaining a healthy weight, eating nutritious foods, abstaining from smoking, and manage chronic conditions.
- Know your family history because many eye diseases are hereditary.
- Use protective eyewear to prevent injuries on the job, while playing sports or doing simple chores around the home.
- Wear sunglasses to protect the eyes from the sun’s ultraviolet rays.
How to observe Healthy Vision Month
- Share the message on social media. The NEI provides a number of social posts – for both Facebook and Twitter – that can be used by doctors, practices and organizations. Graphics – infographs and infographics – and videos are also available for distribution on the NEI website. Use the hashtag #HealthyVision or #HealthyVisionMonth.
- Use your organization’s communication power – if your practice has a newsletter, blog or website, use pre-drafted email newsletter content (also found on NEI resource page) or drop-in article to spread the message.
- Host an event. Get active about promoting healthy vision in your community. Maybe at you kid’s soccer game, or at the church you go on Sundays.
These messages about the importance of eye health are significant to doctors of optometry and the AOA all year round. Many patient education materials supporting the pillars of Healthy Vision Month—such as booklets on nutrition and the importance of proper sunglasses—are available through the NEI website and the AOA marketplace.
For this Healthy Vision Month, let’s take care of our eyes to make them last a lifetime.
Thank you for reading the newsletter. Please don’t hesitate to contact me at email@example.com with any questions you may have!
When To Worry About a Mole
By Michael J. Ammar, MD
Retina Consultants San Diego
Dear SDCOS friends,
For this month’s Retina Corner we will be touching on an important diagnosis we see frequently in our clinics, choroidal nevi.
Choroidal nevi are benign tumors of the uvea that are made up of melanocytes. They are the most common benign intraocular tumor. Similar to skin nevi, they are quite common and can vary in size, location, and appearance (figure 1). Choroidal nevi are often benign and asymptomatic, and it is not unusual for them to go unnoticed until spotted on a routine eye exam. While they are the most common benign intraocular tumor, they are still relatively rare with a prevalence of only 2.1%. Some may be more likely to develop nevi such as individuals who have fairer complexions. In regard to age, studies have had variable outcomes as to whether any association exists between age and the prevalence of nevi. There is no significant difference between genders.
Ophthalmic examination often reveals a pigmented lesion with varying associated features. These lesions are usually small but can vary in size from under disc diameter to greater than five disc diameters. They are often circular or oval in shape and flat or minimally elevated (<2mm thick). Pigmentation can vary and less commonly lesions may be amelanotic. Additional findings with clinical significance include the presence of absence of drusen, sub-retinal fluid, orange pigment, and choroidal neovascularization (CNV). It’s crucial to assess every nevus for these features as they can be associated with increased risk of malignancy.
Benign or Malignant?
Most nevi are benign however malignant transformation is possible and nevi must be carefully assessed for any concerning features. It is estimated that 1/8845 nevi will undergo malignant transformation each year. Extensive discussion and research has gone into identifying these characteristics. Landmark studies by Shields et al. identified risk factors predictive of growth of choroidal melanocytic tumors. These studies identified the following critical features in the evaluation of the malignant potential of a choroidal nevus: thickness over 2 mm, subretinal fluid, symptoms, orange pigment, tumor proximity within 3 mm of the optic disc, ultrasound hollowness, halo absent, and drusen absent. A mnemonic commonly used to abbreviate these risk factors is To Find Small Ocular Melanoma Using Helpful Hints Daily (TFSOMUHHD).
Early identification of a malignant mass can mean the difference between life and death. Malignant lesions may easily masquerade as benign choroidal nevi and appropriate diagnosis can be challenging. The most important tool in the proper assessment of these lesions is a comprehensive clinical exam but ancillary tests still provide critical information. These tests include ultrasonography, fluorescein angiography, indocyanine green angiography, enhanced depth imaging optical coherence tomography, autofluorescence, and fine needle aspiration biopsy.
Asymptomatic choroidal nevi without any concerning risk factors can be monitored with serial examinations and appropriate imaging every 4-12 months. This interval may be shortened if there is increased concern for malignant transformation. The management of malignant melanoma is much more complex and there is considerable debate about how best to approach these tumors. Depending on the clinical presentation, possibilities include observation, transpupillary thermoplasty, plaque radiotherapy, charged particle irradiation, external resection (exoresection), internal resection (endoresection), enucleation, orbital exenteration, systemic chemotherapy, and systemic immunotherapy.
The prognosis for choroidal nevi is very good. The majority of patients with these lesions will be completely asymptomatic and never develop any visual symptoms or issues. The lesions are typically stable or grow very slowly over time. However, they can mimic several other lesions that are more dangerous and may require closer follow up and/or intervention. Appropriate management involves monitoring and documentation of nevi size and features in conjunction with ancillary testing and imaging. It is important to keep a low threshold for more dangerous differential diagnosis as they can be vision, eye, or life threatening.
I hope you enjoyed this month’s edition of Retina Corner! If you have any questions or if there is ever anything I can help with, please feel free to contact me at any time.
Best wishes, and until next time,
Michael Ammar, MD
Retina Consultants San Diego
written by Dr. Byron Y. Newman
Check out Dr. Newman’s website, www.thehumorfactory.com!!!
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 CE May 26, 2022, 2-hour CE
Hilton Mission Valley San Diego
901 Camino del Rio S
San Diego, CA 92108
Speaker: Dr. Brittany McMurren
Topic: New Treatments for Dry Eye
SDCOS Members: FREE
COA/AOA Members: $35
Optometrist needed for Saturdays at the Mission Valley Costco. If interested please contact firstname.lastname@example.org (06/22).
Multi-location private practice is hiring a full-time Optometrist. Highly trained staff provide full work-up, latest digital technology, friendly team culture, benefits, competitive pay. Send resume to MichelleKingOD@gmail.com (05/22).
OPTOMETRY PRACTICE FOR SALE: Coastal San Diego County 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. Revenue in 2021 was almost $400K on part-time doctor hours. Plenty of room for growth/expansion. Seller is motivated and willing to assist in the transition. Please contact Allison Robles at Practice Concepts at 714-797-1605 or email email@example.com for more info. (ID#76720) (05/22).
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 firstname.lastname@example.org (05/22).
Former Optometrist office space built out in Carmel Valley for lease- 1755 sq feet available immediately in Trader Joe’s anchored center. Prior tenant merged practices and space is in “Move In” condition. For Information please contact Reg Kobzi at 858-546-4604 email@example.com (06/22).
Looking for a full-time optometrist for an OD/OMD practice at Castillejos Eye Institute in Chula Vista. Hours are Monday-Friday 8-5. Residency and Spanish are preferred but NOT a requirement. The salary starts at $128,000. New grads welcome! If you have any questions you can contact Alex Scovill, OD at firstname.lastname@example.org or our office manager, Olga Ramirez, at email@example.com (06/22).
Maternity coverage needed at Target Optical in South Vista (North County) starting at the end of June. Potential to continue part-time after maternity coverage ends if it’s a good fit for both parties! If interested or would like more details, please email firstname.lastname@example.org (05/22).
PRACTICE FOR SALE: Owner retiring from North County practice of 34 years. Remodeled office located in a professional building near Tri-City Hospital. Perfect opportunity to own your own optometric practice or have that second office location. Priced to sell! Contact Dr. Sherman at email@example.com or cell 760-208-3456. (05/22).
Looking for a fill-in doc for May and June. The days needed are Thursdays, Fridays, and Saturdays at Poway Costco. Weekday hours are 10-6 and Saturdays are 9:30-4:30. Base pay with production bonus. If interested please email: firstname.lastname@example.org (05/22)
Build Ownership in a Growing Optometry Practice, Even as a New Grad. Growing Practice at the Heart of San Diego with a 25+ Year Veteran of the Optometry Profession, with a successful history of growing multiple practices, is seeking a motivated, self-starter, entrepreneurial optometrist to join a growing optometry practice in City Heights. Practice is in a custom modern office setting, with great visibility, with a proven track record of success for medical practices. Working knowledge of Spanish is preferred. Opportunity to get involved (even as a New Grad) in a growing eye care practice from the ground up, earning equity toward part or full ownership. Please email your resume to email@example.com (06/22).
Please contact Dr. Dave Sherman, Society Optometrist Relations Liaison at firstname.lastname@example.org or 760-208-3456 to be put on an official list for the following:
- fill-in/part-time work
- full-time work
- purchase/partner in/sell a practice
This service is offered free of charge to SDCOS members.
Monarch School Screening
Please contact Dr. Meisel at email@example.com if interested in volunteering for the exams on the 15th and 16th of March or for the next vision screening in the fall semester.
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:
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
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 firstname.lastname@example.org
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Welcome, new members!!
- Chi Huynh
Please update your information on www.eyehelp.org
Phone: 619 663 8439
Fax: 800 643 8301