April 2024

As the first quarter of 2024 is now behind us, let's reflect on how busy this year has been. My office continues to be super busy, praise God, and the SDCOS board remains a well-oiled machine. A huge shoutout to Dr. Simona Grosu. She has gone above and beyond in helping to keep the entire board on track since Nancy-Jo retired. Talking about a learning curve for all of us! Dr. Bev Bianes' project, "Diversity is our Strength," continues to grow. Dates will be coming out shortly for all of us to visit and see what is going on. I am so proud of the whole board and what everyone is doing for the good of the San Diego Society. This is why we are one of the top societies in the state and the country. Everyone, hard work pays off.

There has been a change to the CE schedule. We had to reschedule our 5-hour CE because of a conflict with COA. We are working with Dr. Paul Karpecki to reschedule him later in the year. As soon as we know the exact date, we will let everyone know. We have scheduled a very powerful live CE for Thursday, April 25th, at the Mission Valley Hilton. The theme is spring break, and it will be a blast. Two of our own local rock-stars are scheduled. Dr. David Schanzlin will be talking about Artificial Intelligence in Eyecare. I have heard this presentation, and I am so glad that he has agreed to share this with the society. This is where the world is going, and you do not want to miss it; it is powerful. Also, we have Dr. Julio Echegoyen who will speak for an hour on Glaucoma. Both are great speakers with exciting topics. You want to be there for this.

We are all a part of the greatest profession in the world... we get to help people see better and live their lives better every day. It does not get any better than that! Our profession continues to grow because of the dedication of our society board, the COA, and AOA. Please continue to support organized Optometry, especially in these crazy times. Also, remember to read the newsletter in its entirety. A lot goes into making it so informative... thank you, Dr. Alyssa Pack. It's a great way to stay informed. Have a great month, everyone. Take care, and God bless each of you.

Eric

 

OD Relations Liaison

Please contact Dr. Ananya Jalsingh, OD, Society Optometrist Relations Liaison at odjobs@sdcos.org 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

Thursday April 25th, Mission Valley Hilton.
Dr. David Schanzlin Artificial Intelligence in Eyecare 1 hr
Dr. Julio Echegoyen Glaucoma CE (Topic TBD) 1 Hr
Theme: Spring Break

https://bit.ly/HiltonMissionValley

  • 2024 CE Schedule

  • 2024 SDCOS Board of Directors

Volunteer Opportunities

SDCOS was asked to provide volunteer eye care and to join VSP by the San Diego County Office of Education and RN Elly Kobetsky, helping teens at risk with Mobile Vision Clinics in San Diego and El Cajon on March 13th-14th.

Sixty-five students with chronic truancy, acting as single parents, with unstable housing settings, and various other lifestyle challenges were evaluated, and eyewear was prescribed as needed. Drs. Vady Khalil and Sulki Han joined Ketan Bakriwala, Robin Drescher, and Bob Meisel to provide the optometric care.Thirty-nine prescriptions were fabricated on-site, 16 prescriptions will be shipped to the schools due to high degrees of power, and 10 exams resulted in no prescriptions.

For many of these students, the clinics provided them with their first eyewear and, hopefully, a means to better academic success.
 

Looking for volunteers for these future events:

April 13, 2024
 UCSD AMSA health fair

If you would like to volunteer or would like any additional information about these events, please contact Dr Bob Meisel at rmeisel47@gmail.com.

Meet a Member

Dr. Adam Rosa 

1. Which optometry school did you attend?
Southern California College of Optometry

2. What year did you graduate?
2017

3. What is your favorite specialty?
Dry Eye

4. What do you like to do for fun?
Wrestle my 3 kids

5. What is your favorite thing to do in San Diego?
Surf

6. What is something people might not know about you?
I love going on long backpacking trips to the middle of nowhereTBD

Retina Corner

Epiretinal Membranes (ERMs): A Comprehensive Examination of Pathogenesis, Clinical Manifestations, Diagnosis, and Therapeutic Approaches

By Nikolas J.S. London, MD FACS
President, Retina Consultants San Diego

Dear SDCOS,

I hope you are all well! This is my first article of 2024 and I wanted to thank you all for a wonderful year so far. I don’t know about you all, but this year has been a blast for me so far. My most important thing is that I am 100% nerding out on data collection for my household. I am amazed at how much I have missed over the past few years (and how much money I am now able to save). I won’t go into it here, but I’m telling you, check out the following thing if you’re a data nerd and perfectionist like me: Sense, Aquanta, Flume, and Monarch. I’ve also found a great new financial advisor, and the awesome home gym, Tonal. To say I’m obsessed with all of the above would be an understatement. Similar to my love for these, I am similarly passionate about Retina surgery and wanted to go old-school Retina this and talk about one of favorite surgeries – vitrectomy for epiretinal membranes.

Epiretinal membranes (ERMs), also termed macular puckers or cellophane maculopathy, are very common and characterized by the formation of a fibrocellular layer on the surface of the retina, particularly affecting the macula. This article will delve into the scientific underpinnings of ERMs, discuss their etiology, clinical presentation, diagnostic modalities, and therapeutic strategies.

Pathogenesis:

The pathogenesis of epiretinal membranes is multifaceted and not entirely understood. They originate from alterations in the vitreoretinal interface, where the vitreous undergoes age-related liquefaction and posterior vitreous detachment. Consequent to vitreous detachment, cellular elements, including fibroblasts and glial cells, proliferate on the retinal surface, giving rise to a fibrocellular membrane. Additionally, inflammatory mediators and growth factors have been implicated in ERM formation, suggesting a complex interplay of cellular and molecular mechanisms. When I discuss this with patients, I mention that ERMs form as a result of vitreous separation from the macula –vitreous elements are left on the macula following separation, and the act of vitreous separation causes localized inflammation.

Clinical Manifestations:

Clinically, epiretinal membranes present with various visual disturbances, albeit their severity may range widely. Predominantly affecting central vision, symptoms include visual acuity reduction, metamorphopsia, and macropsia. Funduscopic examination may reveal macular striae and reflectivity. Optical coherence tomography (OCT) enables precise visualization of ERMs, depicting their thickness, extent, and degree of retinal distortion.

Diagnosis:

Accurate diagnosis of epiretinal membranes relies on a comprehensive ophthalmologic evaluation, incorporating visual acuity assessment, slit-lamp biomicroscopy, and dilated fundus examination. However, the cornerstone of ERM diagnosis lies in imaging modalities, particularly spectral-domain OCT, which affords high-resolution cross-sectional images of retinal architecture. OCT facilitates not only the detection of ERMs but also the monitoring of disease progression and treatment response.

Therapeutic Approaches:

Management of epiretinal membranes is contingent on the severity of symptoms and visual impairment. While observation may suffice for asymptomatic or minimally affected cases, intervention becomes imperative in symptomatic individuals. Pars plana vitrectomy (PPV) with membrane peeling constitutes the mainstay of treatment for significant ERMs. During PPV, the fibrocellular membrane is carefully removed, restoring retinal architecture and improving visual function. While I often try to talk patients out of surgery, I do highly enjoy performing these cases – it is very satisfying to remove these membranes and to watch the macula improve over the next few months.

Conclusion:

Epiretinal membranes represent a prevalent retinal pathology with diverse etiological factors and clinical manifestations. Advancements in diagnostic modalities and therapeutic strategies over the past few decades have revolutionized the management paradigm for ERMs. A comprehensive understanding of their pathophysiology coupled with early detection and timely intervention is pivotal in preserving visual acuity and enhancing patients' quality of life. Further research endeavors aimed at unraveling the molecular intricacies of ERM formation hold promise for innovative therapeutic modalities and improved clinical outcomes.

Thanks so much for reading this month’s article! Please feel free to reach out anytime via text, email, or call. Always happy to chat about Retina or even just to say hello.

Best wishes, and until next time,
Nik
 

Nikolas London, MD, FACS
Retina Consultants San Diego
415-341-5456 (cell)
london@rcsd.com
www.rcsd.com

Sponsor Spotlight

Al Tyler

Where do you work?
I work for Unifeye Vision Partners which is the holding company for Eyecare of San Diego, Eyecare of La Jolla and Pendleton Eyecare. My primary office location is Eyecare of San Diego at their Sorrento Valley clinic.

How many years have you been in the industry?
I joined UVP 2 ½ years ago and previously worked as the West Coast sales leader for Eyemed Vision Care

What are your favorite activities?
Sunday tennis, Wednesday evening runs on the beach and Friday family dinners.

What is your favorite quote?
“To improve is to change; to be perfect is to change often” Winston Churchill.

Ensuring the longevity of your business

Submitted by: Nichole Mayer & Will Hage of Westpac Wealth Partners

Business owners spend years — perhaps even a lifetime — building their business. And they make a lot of sacrifices along the way. So, it’s important for small business owners to take the necessary steps to protect their business and their family today, and for the future. One way to accomplish this is creating, implementing, and funding a business continuation plan.

Why a business continuation plan?
For many business owners, their net worth and their family’s financial health are tied to the success of their business. A business continuation plan can help identify who would take over the business’s day-to-day operations if the owner is disabled or passes away. It can also define what would happen to a business when one of the co-owners retires.
A business continuation strategy —created with the help of the owner’s business and legal advisors — can help to put the proper plans in place so the business can continue operating, no matter what the future holds. These professionals can also help implement the strategy with a properly funded Buy-Sell Agreement.

How the Buy-Sell Agreement works
A Buy-Sell Agreement is a legal contract that specifies what will happen to an owner’s (or co-owners) business interest in the event they should die, become disabled, or otherwise leave the business. This agreement, when properly funded, can:

  • Establish a ready market to purchase a business interest

  • Establish a value for the purchase price of the business interest

  • Identify the future buyer(s) — typically, the company’s co-owners or key employees

  • Identify the events that would trigger the Buy-Sell Agreement

  • Create a legal obligation for the departing owner to sell his or her business interest, and a legal obligation for the buyer to purchase the interest

  • Provide a source of funds to fulfill the terms of the Buy-Sell Arrangement

Determining the value of the business 
A key component of any Buy-Sell Agreement is the value of the business interest being sold. There are many ways to value a business, and each has its advantages and disadvantages. Seeking an independent appraisal can help determine the fair market value of the business from a qualified appraisal firm that has experience in valuing businesses within their industry.

The benefits of a funded Buy-Sell Agreement
A Buy-Sell Agreement, on its own, is not effective unless it is also properly funded. When that happens, the departing owner or his/her family will receive a fair price for the business interest and, most importantly, preserve and convert business wealth into family wealth. For the remaining owners, the business is able to continue to grow and flourish without the burden of paying a non-productive disabled or retired owner, or having to deal with family members of a deceased owner.

3 ways to fund a Buy-Sell Agreement

  • Business cash flow, cash reserves, or borrowing: While any of these methods may be used, they are typically impractical or expensive solutions. In many cases, the business will have insufficient cash flow to pay the purchase price of the Buy-Sell Agreement — while also paying salaries, recruiting, and training expenses. Cash flow is ordinarily used to pay the day-to-day expenses of the business. Cash reserves are typically used to fund growth activities, not to pay off debt. And loans may be hard to obtain in the wake of the death, disability, or departure of an owner.

  • An installment sale approach: This method can also lead to insufficient and expensive funding because business cash flow is typically the source of the funds used. Installment sales carry additional risk due to the time required to pay off the debt. Time increases the risk of default on payments, insolvency of the business in the future, and the possibility that the deceased or departing owner or his/her family will wish to take back the business, which is contrary to the purpose of the Buy-Sell Agreement.

  • Life or disability insurance: This funding method can provide the funds needed at the appropriate time — upon the death or disability of one of the co-owners. And, it can be one of the most cost-efficient ways to fund a Buy-Sell Agreement.

In conclusion
This article only briefly summarizes important considerations in the business succession planning process. Business owners should work with a financial professional as well as their tax and legal advisors to create their own customized Buy-Sell Agreement, based on their long-term personal and business goals. This team can help to create the Buy-Sell Agreement, and can help to identify the funding method that will best support the business continuation plan.

Prepared by The Guardian Life Insurance Company of America. The information contained in this article is for general, informational purposes only.
1 Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation.
Material discussed is meant for general informational purposes only and is not to be construed as tax, legal, or investment advice. Although the information has been gathered from sources believed to be reliable, please note that individual situations can vary. Therefore, the information should be relied upon only when coordinated with individual professional advice.

The information contained in this article is general in nature and is not legal, tax or financial advice. For information regarding your particular situation, contact an attorney or a tax or financial professional. The information in this newsletter is provided with the understanding that it does not render legal, accounting, tax or financial advice. In specific cases, clients should consult their legal, accounting, tax or financial professional. This article is not intended to give advice or to represent our firm as being qualified to give advice in all areas of professional services. Exit Planning is a discipline that typically requires the collaboration of multiple professional advisors. To the extent that our firm does not have the expertise required on a particular matter, we will always work closely with you to help you gain access to the resources and professional advice that you need.

Any examples provided are hypothetical and for illustrative purposes only. Examples include fictitious names and do not represent any particular person or entity.
Nichole Mayer & Will Hage are Registered Representatives and Financial Advisors of Park Avenue Securities LLC (PAS). Securities products and advisory services offered through PAS, member FINRA, SIPC. Financial Representative of The Guardian Life Insurance Company of America® (Guardian), New York, NY. PAS is a wholly owned subsidiary of Guardian. WestPac Wealth Partners LLC is not an affiliate or subsidiary of PAS or Guardian. Insurance products offered through WestPac Wealth Partners and Insurance Services, LLC, a DBA of WestPac Wealth Partners, LLC. Mayer CA Insurance License Number - 0F54659 | Hage CA Insurance License # 0D97541 | 2024-171753 Exp. 12/24

Eye Care of San Diego – Sorrento Valley Clinic

Eye Care of San Diego is pleased to add a new location in Sorrento Valley. Formerly known as Eyesight and Surgical Institute (ESI), our new location proudly serves patients in nearby communities including La Jolla, Kearny Mesa, and Clairmont to name a few. Our expert team is committed to delivering personalized attention and an extensive array of top-notch services, continuing the legacy of excellence set by (ESI).

Discover a range of advanced eye care services, from comprehensive eye exams to Cataract, Glaucoma, Dry Eye and Oculo Facial consults. This clinic features cutting-edge diagnostic technologies tailored to enhance and safeguard our patient’s vision. Our Sorrento Valley facility is equipped with state-of-the-art resources, ensuring precision and excellence in every aspect of a patient’s eye care journey. Referred patients are currently experiencing minimal delays in receiving appointments at this clinic.

Trust us for specialized services, including cataract surgery and LASIK surgery, as we prioritize visual health. Experience the unparalleled care and commitment that define Eye Care of San Diego. Welcome to a new standard of eye care in Sorrento Valley!

Eye Care of San Diego – Sorrento Valley
5330 Carroll Canyon Road
Suite 210
San Diego, CA 92121
Phone: (858) 450-1010

Classifieds

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 a.m. – 5:00 p.m.) and Saturdays (8:00 a.m. – 3:00 p.m.).  $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 drmikafu@hotmail.com with your resume to apply. (4/24)

Optometrist needed for Mondays, Wednesdays and Saturdays. Located in Del Mar Highlands. Email info@atelieroptica.com. Ro (619)988-2102 (4/24)

Optometric Office in Escondido for lease.  Three operatories, a lab, large front office area, testing rooms, dispensing optician area, large waiting room, contacts room, lounge, ADA restroom, and 2,044 square feet.  Currently occupied by North County Eye Center and available May 2024.  Contact Jim at jimlund08@gmail.com or at (760) 747-7800. (3/24-5/24)

In need of a Saturday Optometrist to join our incredible staff. Saturday salary $600/day plus bonus. Located inside a Target, our community of Eastlake, Chula Vista is warm and family oriented. New equipment in office - Revolution EHR, Marco phoroptor, Optos. Email Pariya.od@gmail.com for more information. (3/24)

Very Busy Optometry Practice inside a large busy retailer. Busy Optometry practice inside a major big box retailer in Eastern Washington. Very Profitable! For more information contact Frank Sciabicaat frank@omni-pg.com or call 425-985-8390. (WAO104)  (4/24)

Highly Profitable Spokane Optometry Practice. For more information Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (WAO110)  (4/24)

West Sound Ophthalmology Practice. For more information Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (WAO109)  (4/24)

West Sound Well Established Optometry practice with 35 years goodwill and adjusted net profit of 350K High-Profit Port Hadlock Optometry Practice. Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (WAO107)  (4/24)

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 hours/per week. Performing CRT/orthoK 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 frank@omni-pg.com (WAO102)  (4/24)

Price Reduced!! High Visibility High Traffic Optometry Practice Near Google Price Reduced!! Long-established, growing practice in close proximity to Google. This practice grosses approximately650K/year and is still growing. Nicely appointed pleasant, high visibility location. This one won’t last long. For more information contact Frank Sciabica at frank@omni-pg.com or call 425-985-8390.(CAO107)  (4/24)

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 frank@omni-pg.com.(CAO105)  (4/24)

New Optometry Practice in Temecula   Very modern date optometry practice in Temecula, California.Collections keep getting better every year. Lots of growth potential. Located in a beautiful area. Seller is very motivated. For more information Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com.(CAO112) (4/24)

Busy Portland Optometry Practice Opportunity to buy an affordable optometry practice in Portland, OR near daily drivers, restaurants, and entertainment. Ready to operate with an established patient base of families and young professionals with new patients weekly. Excellent equipment package including automated exam lanes, updated diagnostic technology and EHR. Contact Frank Sciabica for more info! At 425-985-8390 or frank@omni-pg.com. (ORO101)  (4/24)

Small town Whatcom County vision clinic with 70 years goodwill. Small Town Optometry practice with 70 years goodwill. This practice has been in existence since 1949 and has been providing excellent customer care ever since and is very well known in the community. The real estate is available as well. For more information Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (WAO108). (4/24)

Live Where Others Vacation! Live where others vacation! Well established Optometry Practice established in a very busy strip mall with major retailers. Located in the Palm Desert area. High-end clientele. Practice grossing $800K with great net income. For more information Contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (CAO110). (4/24)

Well established Kirkland practice grossing 425K in nice professional building next to medical offices. Well established Kirkland practice grossing 425K in nice professional building next to medical offices. Low key environment with long term staff and low overhead. Seller will stay on for transition. Nicely appointed with room to expand. For more information contact Frank Sciabica at 425-985-8390 or frank@omni-pg.com.(WAO111) (4/24)

Cosmetic Ophthalmology Practice Long-established, medium-sized Cosmetic Ophthalmology clinic located in South King County. Located in a nice professional center. Call Frank Sciabica at 425-985-8390 or frank@omni-pg.com. (WAO101).For more information visit Omni Optometry Practice Group: LISTINGS - Omni Optometry Practice Group(omnipg-opto.com) (4/24)

Optometrist needed any day of the week at the Mission Valley Costco. If interested please contact rslikker@san.rr.com or 619.977.7703 (4/24)).

Associate OD needed at the Vista Costco. 3-4 days per week available. Base pay + bonus. Hours: Mon-Fri 10-6:30  Sat 9:30-5. Email kmichel@vistaoptometry.net with resume and availability (2/24)

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 spousti@live.com (2/24)

Looking for a motivated business-minded optometrist who is tired of the daily grind of a corporate practice, and wants to be their own boss while building equity. Our dynamic, high-potential private optometry practice is seeking an optometrist who is passionate about providing exceptional eye care and looking to take their career to the next level. With us, you won’t have to work 9 hours a day in a corporate practice, just to make a modest $500-$600 per day. Instead, you can earn much more and work just a quarter of the time you would have to spend in a corporate practice. Plus, you’ll have the opportunity to build equity in the practice, meaning your hard work will pay off in the long run. If you’re ready to add a second location or if you are a new grad, we want to hear from you. Please email us at: spousti@live.com (2/24)

Wanted: Used, good condition, Retinal Camera and Autorefractor. We are looking for a reliable non-mydriatic retinal camera and autorefractor for our optometry practice. If you have recently upgraded and no longer need your used one, we appreciate you reaching out to us. Thank you. spousti@live.com (2/24)

Exceptional Opportunity: Thriving Optometry Practice & Prime Medical Office Building in San Diego FOR SALE, with the REAL ESTATE. Unlock the potential of your optometry career with this golden opportunity! Highly profitable and growing optometry practice for sale in Central San Diego, together with its modern Medical Office Building. Discover the perfect blend of profitability and growth in this dynamic location (the second most active redevelopment zone, after downtown, in San Diego). Whether you're starting a new practice or expanding an established one, this is your chance to shine in a highly dense area, strategically positioned near more than 80 schools and 9 minutes from Downtown San Diego, and surrounded by 4 major freeways. Step into the future of healthcare with a contemporary medical office building, featuring three separate suites, that can be joined if needed into one big clinic and a total of 7 highly upgraded and move-in ready exam rooms. What sets it apart? Half of this impressive structure can be leased to other medical professionals, delivering a steady income stream, while the other half continues to house the thriving optometry practice. Seize the moment to drive your practice's growth while building equity in a high-potential, modern commercial real estate property. This isn't just an opportunity; it's a game-changer for those who dream big. For more details, please reach out via email (bnemati@earthlink.net).  (2/24)