January 2025

Happenings of the Society

On behalf of the San Diego County Optometric Society Board, I would like to wish all of you a most Happy New Year!  May you and your loved ones be blessed with good health and prosperity in 2025.

Some of you may be familiar with a well know book by Simon Sinek called “Start with Why”.

The author defines the “Why “as your purpose, cause or belief.  Simon Sinek encourages us to think beyond the obvious and go back to the root cause of why we do what we do.

As we launch into 2025, I would like all of us to take a moment and reflect on why we are part of this society. As members, we are helping to protect and advance our chosen profession.  Every prescribing privilege we have and every duty we perform as an optometrist is defined by the verbiage on a legislative document.  Without the watchful eye of our state and national associations (backed by the local societies), we run the risk of losing the freedoms we now enjoy.

As important a reason as I just described, I would like to challenge our members to expand their “Why” with regards to SDCOS membership.  An integral part of the mission of our society is to give back to our community.  Throughout the year there will be multiple opportunities to volunteer your time and talents to those in need.  Please consider participating when the opportunity presents.

Our first CE meeting will be held on February 13 at our beautiful new and easily accessible venue in Carmel Valley.  Apart from the top-notch speakers and gourmet catering, these gatherings provide opportunities to visit with old friends and make new ones as well.  This first meeting of the year is free to members and non-members alike, so I encourage you to invite a colleague that has lost sight of their “Why” in the hopes that they come to understand and appreciate the value of professional society membership.

I am truly honored to serve alongside an incredible board that unselfishly volunteer their time and talents to this society.  Please reach out to me or to any of them if the need arises.  Again, best wishes in this new year!

John C. Pack, O.D.
SDCOS President 2025
jpackod@yahoo.com
(619) 806-1282

Upcoming CE Meeting

Thursday, February 13

NEW LOCATION: WestPac Headquarters: 5280 Carroll Canyon Rd Suite 300, San Diego, CA 92121
https://www.westpacwealth.com/

Gary Gerber, O.D.- Myopia Management Secrets Unlocked (1HR)
Kimberly Cockerham, M.D.- Neuro Pearls and Pitfalls (30 min)
Catherine Sheils, M.D.- Glaucoma (30 min)

Looking for Volunteers for these future events:

Looking for Volunteers for these future events:

SDCOS Project of the Year: School Screenings at all 12 of the South Bay schools. School locations will be announced as we get closer (all located in South Bay)
(8 am-12pm)

  • Wednesday January 22nd (2025)

  • Monday February 3rd (2025)

  • Wednesday February 19th (2025)

  • Monday March 17th (2025)


Please contact:
rmeisel47@gmail.com
(C) 619-818-3031

After the SDCOS led vision screening at the Monarch School in October, 43 students were referred for further evaluation. The exams took place November 12-13th . With the assistance of the 5 member VSP Mobile Clinic team, the students and a few parents were examined for eyewear by Drs. Grosu and Meisel. 46 needed refractive help while 2 did not require an Rx. VSP  fabricated all the eyewear at it’s laboratory and sent the items to the school. This semi-annual SDCOS program has been in place for over 15 years to help unhoused students with their visual needs.


The SDCOS South Bay Unified School District vision screening project started in August and concluded Phase 1 in early November. After screening several hundred students at many elementary schools, the referred students were scheduled to have exams with the VSP Mobile Clinic November 12-16th . Several SDCOS volunteer docs performed exams on 96 students. Eighty-five prescriptions were provided and 11 did not need any eyewear. VSP provided pretesting, exam equipment, frame choices, and fabricated the eyewear for those students in need. Drs. Grosu, Hillier, Lavin, and Medina joined Drs. Meisel and White in providing the exams. December will start Phase 2 as more students will be screened until mid March.

If you are available to help with the screenings or with exams, please let Dr. White or Meisel know.
 

Meet a Member

Hunter Morgan, O.D.

From: a small town called Fairmont, West Virginia

Schooling: University of Kentucky - 2013 (Go CATS!)

Southern College of Optometry - 2017
Ocular Disease Residency at Bronx Care Health System in Bronx, NY -2018

Work: I work at a private practice in Encinitas & Carlsbad

Favorite Specialty: Specialty Contact Lenses

Hobbies: My newest hobby is taking care of my 6 month old son with my wife, Sloan. It's been a blast and I'm excited to see how this year will change. I also enjoy getting outside, exploring new food spots, and sports.

Pearl of Wisdom: After practicing in multiple settings I have learned that it is truly important to take care of your team/coworkers. We spend a lot of time each day with our coworkers and if our team isn't happy, then it is reflected in the quality of patient care & experience. Our coworkers can feel like a second family so making sure they feel heard, respected and valued makes a huge difference in the office morale. Some ways to show that we care can include getting to know their hobbies, stepping in for them when they've had a tough day, and even celebrating special occasions with them (birthdays, big life moments, etc). After all, your work family is what gets you through the good days and the bad. So celebrate the wins together and learn from mistakes as a team.

Retina Corner

Rhegmatogenous Retinal Detachment in Young Adults

By Michael J. Ammar, MD
Retina Consultants San Diego

Dear SDCOS friends,

In this month's Retina Corner, I wanted to discuss a passion project of mine that was designed to answer how best to approach rhegmatogenous retinal detachment (RRD) surgery in young adults. While single surgical anatomic success (SSAS) and other outcomes for adult and pediatric primary RRD have been well described in the literature, data regarding those in the intermediate age range, i.e., young adults, have been limited. Recently, a small study from Israel examined anatomic and functional outcomes in young adults aged 18 to 40 undergoing scleral buckle (SB), pars plana vitrectomy (PPV), or pars plana vitrectomy and scleral buckle (PPV/SB), and showed that SB had the best visual outcomes, while anatomic success rates were similar between the three groups. Another larger study of pediatric plus younger adult Japanese patients with a range of 2 to 49 years showed similar results.

In older adults, many studies have overall shown similar SSAS rates among SB, PPV, and PPV/SB. A large meta-analysis showed that there was no difference in single operation re-attachment rate between SB and PPV +/- SB for phakic or pseudophakic patients. However, certain patient characteristics may favor one surgery type over another. PPV can be an effective option in older adults as they are more likely to be pseudophakic, have a complete PVD, and a less adherent posterior hyaloid. This facilitates the more complete removal of the vitreous and associated traction and decreases the risk of iatrogenic retinal breaks. It is also a faster, less complex surgery with a lower risk of complications like diplopia, infection, and significant anisometropia. A SB alone is still an effective option in older adults or in combination with PPV. SBs offer many benefits in that they provide support to the vitreous base to counteract tractional forces of proliferative vitreoretinopathy (PVR), and do not impact the rate of cataract formation in phakic patients. However, there are also studies that argue for superiority of one surgical type over the others.

The management of pediatric RRDs has been well described and differs significantly from that of adult RRDs. SB is generally preferred to PPV in children because young patients will have a highly adherent posterior hyaloidal face that can make complete hyaloidal separation with PPV challenging, and at times, not possible. PVR can also be relentless in children, especially in the setting of failed vitrectomies. Lastly, post-operative positioning is important for surgical success for patients undergoing vitrectomy, and pediatric patients may struggle to adhere to these directions. These are some of the factors which favor SB or PPV/SB as the surgery of choice in pediatric patients.

In this study, 165 eyes met inclusion criteria out of 260 cases that were initially identified. SB was performed in 91 eyes (55%), PPV in 32 eyes (19%), and PPV/SB in 42 eyes (25%). The median age of the entire group was 37 years. The SB group had a median age of 33 years versus a median age of 41 for the PPV group and 39.5 years for the PPV/SB group, respectively. Patients who underwent SB had the greatest frequency of lattice identified preoperatively (75.4%, p = 0.003) and were all phakic (p < 0.0001). Eyes that underwent PPV or PPV/SB were more likely to have PVD (PPV = 43.5%, PPV/SB = 53.1%, SB = 22.2%, P = 0.007), and be pseudophakic (PPV = 17.4%, PPV/SB = 31.3%, SB = 0%, p < .001).

SSAS rates were 79.3% for PPV alone, 83.7% for primary SB, and 92.7% for PPV/SB (ANOVA p = 0.25). The SSAS rate was 85.3% for all eyes which was higher than expected for this age group. That is higher than some reported numbers for older aged retinal detachments which are generally less difficult to repair. SSAS rates among SB, PPV, and SB/PPV did not show significant differences, and eyes that underwent SB had better postoperative VA than PPV or PPV/SB. Further analysis showed that after adjusting for various factors, including preoperative visual acuity, PPV alone had a significantly higher risk of redetachment compared to PPV/SB. Eyes that had PPV/SB were less likely to result in good vision compared to eyes that underwent SB alone (OR:  0.26, 95% CI: 0.07 – 0.94, p = 0.04). Similarly, eyes that underwent PPV alone were less likely to obtain good vision compared to eyes that underwent SB alone (OR: 0.20, 95% CI: 0.05 – 0.81, p = 0.02).

In summary, for primary uncomplicated RRD among the young adult population, we found that SB, PPV, and PPV/SB have comparably high SSAS rates. However, after secondary analysis, PPV/SB was found to have the lowest risk of redetachment, and this reached statistical significance when being compared to PPV alone. Overall, the majority of eyes went on to achieve final VA of 20/40 or better. Primary SB had the best final VA, outperforming PPV even when controlling for preoperative VA. Our data suggests that for young adults, consideration of primary SB or PPV/SB may confer superior results compared to PPV alone, although individual patient characteristics need to be taken into consideration.

I hope that you found this month's Retina Corner informative and insightful. You can look out for our article in the upcoming issue of JVRD. If you have any questions or if there is anything I can assist you with, please don't hesitate to reach out to me at any time!

Best wishes, and until next time,

Mike

Michael Ammar, MD
Retina Consultants San Diego
480-323-9196 (cell)
ammar@rcsd.com

How to Remove “i Can’t Retire” From Your Planning Mindset

This article provides three ways for business owners to more successfully plan for retirement, along with the consequences of taking these actions.

There’s a big difference between not wanting to retire and not being able to retire. Even business owners who intend to die at their desks can appreciate the safety net of financial independence should something unexpected occur. But many business owners look forward to an ideal future without implementing the proper planning to achieve it.

Today, we’ll discuss ways to mitigate the risk of not having enough money to retire on your terms.

Start by understanding the Asset Gap

A common mistake successful business owners make is assuming they have more than they need, while assuming they need less than they do. The difference between what you currently have and what you must have to achieve financial independence is called the Asset Gap.

Understanding your Asset Gap is critical to mitigating the likelihood that you won’t have enough money to retire. (And even if you intend to work until you die, knowing your Asset Gap is crucial to achieving other goals, such as providing generational wealth for family or leaving a lasting business legacy.)

There are several things you can do to begin determining your personal Asset Gap.

  • Obtain a professional business valuation

  • Accurately assess your net worth with help from your CPA

  • Discuss your vision of an ideal future with a trusted advisor


Obtaining a professional business valuation helps you understand what you need to do to reach a value that will one day allow you to retire with financial independence.

Accurately assessing your net worth can have two positive consequences. First, it gives you an idea of what you’re working with. Second, it can help you dispel misperceptions about what you want in retirement (more on this shortly).

Discussing your vision of an ideal future with a trusted advisor can help you map the steps you need to take to reach that ideal future. It can also show you if your ideal future is realistic, which can reduce the likelihood of taking an impossible path.

Be realistic about your wants and needs

Retirement is a dream for many business owners. But that dream can turn into a nightmare if you don’t know what it will take to fulfill your wants and needs.

For example, many business owners underestimate how long they’ll live. This underestimation can create a financial bind where they simply don’t have enough money to maintain the quality of life they’ve gotten used to. There are vanishingly few, if any, business owners who want to have to scrimp and save to survive their golden years.

Instead, it’s a good idea to determine some of the following facts:

  • How long you and your spouse/partner are likely to live after your retirement

  • How much money you must have to fulfill your needs in retirement

  • What you intend to do in retirement, and how much it will cost you


It’s a risky proposition to “figure it out as you go.” If you can figure these things out while you’re still in control of your business, you’re more likely to make decisions from a position of strength, rather than from a position of desperation.

Look before you leap

Retiring without financial independence is a huge gamble. However, understanding your Asset Gap, along with what you want and need from retirement, are two strong ways to work toward financial independence.

Nonetheless, pursuing retirement on your terms can be full of surprises.

For instance, you may want to transfer your business to a child, only to find out that the child was only still in the business to make you happy and has no intention of running it when you leave.

Likewise, you may decide you want to sell your business to a third party, only to find that while they will pay you enough for financial independence, they also plan to lay off 95% of your workforce when you leave.

Trying to anticipate these surprises by yourself is often a fool’s errand. After all, you’re still running a business that many people—including yourself, your family, and your employees—rely on. But with help from a dedicated Advisor Team, you can more deftly anticipate and plan for contingencies and surprises on your way to retiring on your terms . . . even if that means never retiring at all.

We strive to help business owners identify and prioritize their objectives with respect to their businesses, their employees, and their families. If you are ready to talk about your goals for the future and get insights into how you might achieve those goals, we’d be happy to sit down and talk with you. Please feel free to contact us at your convenience.

Will Hage: P: 619-417-2432, Will.Hage@WestpacWealth.com

Nichole Mayer: P: 619-684-8625, Nichole.Mayer@WestpacWealth.com

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.

This is an opt-in newsletter published by Business Enterprise Institute, Inc., and presented to you by our firm.  We appreciate your interest.

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 Representatives 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 #0F54659 | Hage CA Insurance License #0D97541 | 2024-174182 Exp. 05/26

San Diego Wildfire Preparedness

Living in San Diego county has so many distinct advantages and that’s why we choose to live here. Now residing in Alpine on 3 acres with two equines, a dog and an obligatory cat for country living, Lois and I have the onus of guarding our critters and property against wildfires. We’ve been evacuated three times in 22 years, with the most recent in September 2020. Fortunately, fire crews have been able to ward off potential devastation. In 2020, the fire was close enough to melt my plastic trash can. After evacuating all of the animals earlier in the day, I was certain when I drove away at midnight, that the house and all the buildings were as good as gone. We were blessed to avoid any destruction that day, but it brought back memories of the Normal Heights fire of June 30, 1985. While on a very long walk that morning, a canyon fire started and ended up burning 76 houses and damaging dozens of others. Our home was leveled and everything in it was gone due to a fire “in the middle of San Diego.”

Technology has changed but a few helpful tips may still help some of you prepare:

  1. Annual insurance update to be certain your policies are adequate

  2. Have a photographic record or video documentation downloaded of the interior and exterior of your property to remind yourself of what you have for insurance claims

  3. Make a list of items you would most like to take if you needed to evacuate in a hurry

  4. Have an evacuation plan in place for an emergency

  5. Have smoke detectors (and CO monitors) in working order

  6. Keep defensible space around your home and other buildings

  7. Fireproof safe for your important documents


Hopefully, these reminders will help prevent any unwanted issues in the event of a fire: urban blaze or a back country wildfire.

Classifieds

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. (01/24)

Moreno Valley High Visibility Well-Established Optometry Practice. Well-established high visibility optometry practice grossing 500K with more room to grow. Contact Frank - 425-985-8390 or frank@omni-pg.com Lic.#2091491 (CAO114)

NDA Request: https://listings.omni-pg.com/nda-request-form (01/24)

Professional Optometric practice for sale, Ramona, California. Dr. is retiring after 45  years. All offers considered. Current owner has been working with visually impaired children, her granddaughter included. She has a standard life teaching credential as well as her optometry license. Please call (760) 315-2761 if interested. (12/24)

Part-Time Optometrist Needed, Half Day Shifts: We are offering an excellent opportunity for a dedicated Optometrist to join our highly-rated and stress-free practice. Enjoy highly competitive pay, including bonuses, for working just 2 to 3 half-day shifts per week. Our environment is professional yet relaxed, as evidenced by our excellent reviews and the satisfaction of our patients, making your work hours a breeze. If you are motivated and passionate about eye care, we would love to hear from you.  Fluency in Spanish is preferred.  Please submit your resume to bnemati@earthlink.net or contact us via text at 858-504-2020 to apply. (5/24)

Busy Private Practice looking for an associate OD in San Diego and Camp Pendleton military base. Generous base pay plus easy daily bonus pay. Please send resume and questions to:  marineeyecare@gmail.com (7/24)

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)

Read Newsletters

Learn More