The San Diego View
THE MISSION OF SDCOS IS TO SERVE THE PUBLIC AND ITS MEMBERS
THROUGH EXCELLENCE IN COMMUNITY SERVICE, EDUCATION, AND LEADERSHIP.
Happenings of the Society
Upcoming events you don’t want to miss!
April 16th is SDCOS’s 5-hour CE event. We’re putting the fun back into learning in San Diego! Dress in your favorite sports team gear and learn about “The Urgency to Treat Myopia, Not Just Correct It” by Dr. Justin Kwan. Also, new to the format of our 5-hour CE events this year, we are encouraging society members to bring one of their staff members for FREE to learn about “The Transformation of Eyecare from Emerging Trends” and “Building Sales Without Selling” given by practice management guru Jay Binkowitz.
We would also like to encourage members to attend Legislative Day in Sacramento on April 18th. Limited spaces are available. If you’re interested, please sign up quickly. Society delegates from different regions of California discuss with their elected officials the current state of our profession, the expansion of scope, and other legislative initiatives. If you’ve never gone before, consider joining us this year. It’s an amazing experience and an essential part of advocating for our profession.
OD Relations Liaison
Please contact Dr. Melanie Langford, Society Optometrist Relations Liaison at email@example.com 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.
Upcoming CE Meeting
April 16, 2023, 5-hour Meeting
Location: Hilton San Diego Del Mar – 15575 Jimmy Durante Blvd, Del Mar, CA 92014
Speaker: Dr. Justin Kwan
Topic: 3-Hours - The Urgency to Treat Myopia, Not Just Correct It
Speaker: Jay Binkowitz
Topic: 2-Hours - The Transformation of EyeCare from Emerging Trends: Welcome to the Golden Age of Optometry. Building Sales without Selling
AMSA health fair
- Saturday 15 April 09:30 AM - 2:30 PM
Montgomery-Waller Park, National City
SDCOS member Dr Carl Hillier (far R) and Dr Joe Ambrose joined program coordinator Dr Bob Meisel (far L) as they performed
80 exams on Monarch students referred from an earlier screening and for a few parents
Welcome New Members
- Christopher Abbott
In early March, the VSP Mobile Clinic drove south from Sacramento to the Monarch School to provide facilities onboard for 2 days of vision exams.
This cooperative effort has been a huge success in providing no-cost exams and eyewear for nearly a decade
SDCOS member Dr Carl Hillier (far R) and Dr Joe Ambrose joined program coordinator Dr Bob Meisel (far L) as they performed 80 exams on Monarch students referred from an earlier screening and for a few parents
Meet a Member
Dr. Bruce Nguyen, O.D.
1. What Optometry school?
Marshall B. Ketchum University
2. When did you graduate?
I graduated in 2011 and have been in practice for 12 years now.
3. What is your favorite specialty?
Myopia Management and Keratoconus
4. What do you like to do for fun?
I enjoy cooking, listening to audiobooks, and playing fetch with my German Shepherd.
5. What is your favorite thing to do in SD?
Going to the La Jolla shore for the seals
6. What is something people don't know about me?
I built the optical display cabinets at my new practice by myself.
Pearls of Wisdom from an OD
Graduating from the UC Berkeley School of Optometry, he is currently the doctor of the only Sam’s Club in San Diego. He has been a member of the American Optometric Association, California Optometric Association, and San Diego Optometric Society for over twenty years. He was a member of the President's Lions Club and used his expertise to conduct free vision screenings and health fairs for the community of San Diego. He currently has his own wellness show on Vietnamese Television (VNTV) that helps address different aspects of health. He is also the vice-chair on the board of directors for ACMA (Asian Culture and Media Alliance) to help empower the Asian community for a stronger voice in society. Pearl of wisdom is to provide compassionate quality patient care and the new patient referrals will come automatically.
1. I work at EyeCarePro, the leader in digital eye care marketing.
2. I'm in my 8th year in the eye care industry, all of them at EyeCarePro!
3. I enjoy playing and watching hockey, singing, playing the drums, going to concerts, and trying to keep my plants alive.
4. "You miss all the shots you don't take"
Wayne Gretsky - Michael Scott - Lenny Block
Intraocular Lens Options in 2023
By Rakhi Melvani MD and Julio Echegoyen MD PhD
Gordon Schanzlin New Vision Institute
Dear SDCOS Colleagues,
It is my pleasure to introduce you to an amazing new Cataract and Refractive Surgeon in town, and our new associate, Dr. Rakhi Melvani. Dr. Melvani is a native of Southern California, who grew up in Apple Valley. She attended undergraduate and medical school at Virginia Commonwealth University, trained in ophthalmology at the world renown Wills Eye Hospital in Philadelphia and is finishing her Cornea, Refractive Surgery and External Disease fellowship at my alma mater UC Irvine. She comes with the upmost, highest recommendations from all her mentors. We are so pleased to have her join us starting in Summer 2023! She can be reached anytime by cell or email and I am sure she would love to hear from you all so she can get to know our wonderful community. Dr. Melvani volunteered to write this month’s article on an exciting and everchanging topic in the field of anterior segment surgery – intraocular lens options and patient selection for cataract surgery. Your patients may ask you about what their options are for cataract surgery, and so this is an excellent summary that should empower you to start these conversations with them. Of course, you can always reach out to us for more details. Take care everyone!
Hi everyone, thank you Dr. Echegoyen for the kind introduction! I am thrilled to be discussing the exciting topic of intraocular lens selection with you. One of my favorite challenges as a refractive cataract surgeon is helping patients discover their full visual potential with cataract surgery. Until the 1990s, the decision was fairly simple- you have cataracts? Time for surgery with implantation of a standard monofocal intraocular lens (IOL). However nowadays, the choices are endless thanks to the many incredible advances we have made in intraocular lens technology. It has taken plenty of trial and error, but today we are able to truly customize a patient’s vision better than ever before. That being said, it can be overwhelming for our patients to have to learn that they need surgery, set expectations, understand the process and recovery, AND choose the appropriate intraocular lens to implant in their eyes, all in one short office visit. It’s important to gather from the patient a thorough examination, as well as their preferences and visual goals after surgery, to help them decide which intraocular lens is best for them.
The tried-and-true monofocal IOL continues to be an excellent choice for patients. For patients with moderate to advanced glaucoma, or retinal disease such as PDR or AMD, monofocal IOLs allow the maximum amount of light to the retina with minimal light energy lost in comparison to other intraocular lenses. They give the best contrast sensitivity and the lowest risk of higher order aberrations and are covered by insurance. One of the newer monofocal options on the market is the Eyhance one-piece monofocal lens from Johnson & Johnson Vision, that provides about 0.5 diopters of additional range. This IOL has been a real game changer in that it gives us an opportunity to provide even our patients who opt for monofocal IOLs some additional range, without compromising on contrast sensitivity or causing side effects of increased halo and glare due to lens design. The Eyhance IOL has been an excellent addition to our armamentarium especially for those patients opting for monovision- in many circumstances these patients can achieve spectacle independence given the additional 0.5 diopters of range in each eye. Eyhance does also come in toric options which can correct up to about 4 diopters of regular astigmatism in the corneal plane.
For those patients who prefer to achieve full spectacle independence, multifocal IOLs are an excellent option. By definition, these IOLs provide more than one focal point. They were previously only available as bifocal lenses, which lacked intermediate range vision, however now the most commonly used multifocal IOLs are either trifocal or extended depth of focus lenses. Trifocal IOLs such as Synergy by Johnson and Johnson Vision and Panoptix by Alcon give a range of distance, intermediate and near but are considered sharpest at near. In contrast to trifocal IOLs, extended depth of focus IOLs such as Symfony by Johnson and Johnson Vision give excellent sharp distance, as well as intermediate and some near. A popular choice among patients who want full range of vision with no dependence on spectacles is to mix and match multifocals such as placing a Symfony in the dominant eye and a Synergy in the non-dominant eye.
While multifocals are a fantastic example of IOL technology helping achieve spectacle independence, patient selection is crucial to success when it comes to utilizing this technology. Multifocal IOLs rely on a perfect optical system in order to function. Therefore, if a patient has other ophthalmic disease such as significant retinal pathology affecting the fovea, glaucoma affecting their visual field, or corneal scarring causing irregular astigmatism and higher order aberrations, multifocal IOLs may not work as well and can often cause more side effects than a monofocal IOL. The exception to this rule is the Vivity IOL by Alcon which has a non-diffractive profile compared to other multifocal IOLs and can be used in cases such as mild glaucoma or dry AMD. It’s also important to counsel patients that multifocal IOLs will cause halos and glare when looking at a point light source, especially at night, with the lowest risk of these side effects with use of the Vivity IOL.
The newest IOL technology available in the US are Light Adjustable Lenses by RxSight. The light adjustable lens is a silicone IOL that can be implanted during the time of surgery and later adjusted to the appropriate power the patient desires. The IOL power that is chosen is within the ballpark of the patient’s desired power, either distance or near, and can later be treated by up to 2 diopters of sphere and 2 diopters of astigmatism. This allows patients to achieve highly customizable vision, and even have a chance to “try out” their new vision before locking it in place. The IOL is filled with unpolymerized macromers that become photopolymerized upon treatment with UV light. This causes unpolymerized macromers to move into the exposed area, causing precise changes in shape, and ultimately power, of the lens. Up to three treatments can be completed to adjust the IOL power. Once the patient is happy with their vision, two additional treatments are done to expose the entire IOL to UV light and polymerize all remaining macromers, resulting in a “locked in” lens. The treatments can typically be started about two to three weeks after the IOL is implanted, when the patient has a stable refraction, and the IOL can be locked in as early as 3-4 weeks post operatively. While awaiting treatments, the patient must wear UV protective glasses to ensure there is no inadvertent treatment of the IOL from natural UV light. While the light adjustable lens has truly been revolutionary for the field of cataract and refractive surgery in general, the patients it has been most applicable for are those who have undergone laser vision correction. Notoriously our calculations are imprecise for these patients and they are more prone to having myopic or hyperopic shifts after standard IOL implantation despite our best efforts to prevent this. The light adjustable lens allows us to precisely “dial in” these patients desired prescription and avoid these shifts commonly seen with LVC patients. By the way, Dr Echegoyen underwent refractive lens exchange utilizing the Light Adjustable Lens!
To summarize, IOL selection is exciting and challenging with our amazing advances in the field of cataract surgery! IOL selection should be tailored to each patients’ unique exam, history, and visual goals.
I am so excited and privileged to be joining Gordon Schanzlin New Vision Institute this summer! I am greatly looking forward to getting to know and work with you all in the coming months. If I can answer any questions or if there is ever anything I can help with, please contact me anytime.
Rakhi Melvani, MD
Gordon Schanzlin New Vision Institute
Richard Rex Memorial Fund
Richard Rex practiced optometry in San Diego for 13 years prior to his death in an airplane crash in 1989 at age 42. He was a member of SDCOS and specialized in contact lenses at Kaiser Permanente.
In 1991 some of his family, and colleagues established the Richard Rex Memorial Fund in his honor. This fund is used to assist patients in need to obtain eyeglasses, contact lenses, or low vision aids from SDCOS optometrists that have donated their exam time. Children are given high priority, as are patients needing contact lenses for medical purposes.
If you wish to contribute to this fund, please make checks payable to:
Dr. Richard Rex Memorial Fund
C/O SDCOS 11835 Carmel Mountain Rd. Suite 1304-211
San Diego, CA 92128-4601
Optometrists may apply for payment of a maximum of $100 to cover material costs for such patients. If you have questions or would like to request an application, please contact the SDCOS office at 619 663-8439.
All contributions are tax-deductible.
Robert Gonzalez O.D. is looking for a fill-in for 2 1/2 weeks in June for his practice Lake Murray Optometric Center. Please contact him at 619-464-2076 for more information.
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 firstname.lastname@example.org (04/23).
Part-time or Full-time OD needed – Competitive pay with bonus opportunities and a flexible schedule. Hours are available at both Target Opticals in Encinitas and Balboa. Email resume to email@example.com to find out more. (05/23).
Orange County Optometry Practice Orange County Optometry Practice. Ideal merger candidate. $340,000 gross. 30+ years of goodwill. Great location! Good visibility. Contact Frank Sciabica at 425-985-8390 or firstname.lastname@example.org. (CAO105) (04/23).
Grand Vision Optometry (independent family private practice in North County San Diego) with 2 locations in San Marcos is looking for a Part-Time Associate OD for Fridays (8:30 am – 5:00 pm) and Saturdays (8:00 am – 3:00 pm). $500-$525/day base pay with a production bonus of up to $625/day. Exam appts are booked every 30 minutes, an optical technician will pre-test and pre-chart for the doctor. Please email email@example.com with your resume to apply (04/23).
Full-Time OD needed for busy private practice in North County. We offer competitive pay, bonus opportunities, and medical benefits and utilize the latest equipment and technology. Please email your resume to firstname.lastname@example.org (05/23).
Comprehensive Ophthalmology and Eye Care Services Office in Growing Coastal Community with Great Quality of Life. Well-Established Comprehensive Ophthalmology practice grossing approximately $1.4MIL Very profitable. Contact Frank Sciabica for more information at email@example.com or 425-985-8390. (WAO106) (04/23).
Revenue $800,000 on 36 total OD hours. This opportunity includes two practices co-located in one location—huge potential with more efficient operation under one owner. Recently relocated to terrific buildout in a new location next to the hospital; 4 lanes in 2200 square feet. Long-term employees include a bilingual optician. Photos available. Offered at only $295,000 plus sellable goods inventory estimated at $100,000. Seller financing may be available. Contact info@PracticeConsultants.com (05/23).
Optometry Practice for sale: in an upscale shopping center in Escondido, San Diego County, California. Solo Private Practice was established in 1996. Has a large patient base. The equipment is in excellent condition. A full scope Optometry Practice. Complete Sale or buy-out option. Please email firstname.lastname@example.org for details/questions. (04/23).
Busy Portland Optometry Practice Well-established 2-lane optometry practice. Great location in Portland. All the latest and greatest equipment. Very busy! Contact Frank Sciabica for more information at email@example.com or 425-985-8390. (ORO101) (04/23).
Nicely Appointed Optometry Practice in Bellevue’s Tech Corridor Nicely appointed optometry practice in Bellevue tech corridor. Annual collections are $420,000. Adding additional procedures will increase revenue. Lots of parking available. Patient care hours are just 24 hrs/per week. Performing CRT/ortho K for over 20 years. The selling doctor is willing to train buyers on the overall concepts of CRT care to allow seamless continued care with ongoing patients. Contact Frank Sciabica at 425-985-8390 or firstname.lastname@example.org (WAO102) (04/23).
High Visibility High Traffic Optometry Practice near Google Long established growing practice in close proximity to Google. This practice grosses approximately 650K/year and still growing. Nicely appointed pleasant, high visibility location. This one won’t last long. For more information contact Frank Sciabica at email@example.com or call 425-985-8390. (CAO107) (04/23).
Part-time/Full-time OD needed - competitive pay with bonus opportunities. Hours are 10-6:30 pm. Location Chula Vista. Send resume to firstname.lastname@example.org (04/23).
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 excellent opportunity to own your own practice. Contact Dr. Levy at 619-743-1442 or email at email@example.com (04/23).
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 and 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 firstname.lastname@example.org (04/23).
Part-time OD is needed for Fridays 10-6 and Saturdays 9:30-5 at the San Marcos Costco. Exams every 30 minutes. $550 base pay. Please email Dr. Frimtzis at email@example.com (04/23).
Part-time OD wanted. Various days are available for a busy private practice near Oceanside. Easy, young demographic. Competitive pay plus bonus pay. Please email firstname.lastname@example.org, Dr. Steven Thurston (04/23).
Optometrist needed for Thursdays and Saturdays at the Mission Valley Costco. If interested please contact email@example.com or text 619.977.7703 (04/23).