11835 Carmel Mountain Rd. Suite 1304-211
San Diego, CA 92128
June 2025
You Never Know Who You Might Meet...
Last year, my wife Beverly and I had the privilege of attending a Catholic conference at the Vatican. At the end of the week, we were invited to a closing banquet, where we happened to be seated with Cardinal Robert Prevost. We enjoyed a warm and engaging dinner conversation with him and felt truly blessed by the encounter.
Little did we know that just one year later, Cardinal Prevost would be elected as the first American Pope in the history of the Catholic Church!
I share this story to emphasize the unexpected opportunities that come from being present and involved in your community. Here in San Diego, the SDCOS hosts six in-person CE events each year, along with an annual social gathering. These events are more than just a way to meet your licensure requirements—they’re a chance to connect with colleagues, engage with industry representatives, and build relationships that could shape your future.
Come early, stay a little later—introduce yourself to someone new, chat with our sponsors, enjoy a drink and some appetizers. You may not meet the next Pope, but you just might meet your future associate, the buyer of your practice, your next business partner—or perhaps simply make a new friend.
You never know who you might meet.
John C. Pack, O.D.
SDCOS President
OD Relations Liaison
Please contact Dr. Lucia Millet, 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.
Celebrating National Volunteer Month: SDCOS and VSP Mobile Clinics Bring Clearer Vision to San Diego Students
April marked National Volunteer Month, and thanks to the collaboration of two dedicated VSP Mobile Clinic teams and numerous SDCOS member doctors, hundreds of San Diego students are now seeing more clearly and comfortably.
Mid-month, the second phase of the South Bay School District initiative wrapped up successfully. Over three days, Drs. Robin Drescher, Eric White, John Pack, and Bob Meisel conducted 130 comprehensive eye exams for referred students, resulting in 105 prescriptions for new eyewear. This ongoing project, first mentioned by Dr. Pack in the May bulletin, will continue into the upcoming school year. The VSP Mobile team was led by Torry Tripette.
The following week, another VSP Eyes of Hope team, led by Clark Jorgensen, joined forces with SDCOS volunteer optometrists to serve students enrolled in Juvenile Court and Community Schools (JCCS), run by the San Diego County Office of Education and coordinated by RN Ellie Kobetsky. Exams were held over four days at four different educational sites:
National City: Dr. Michelle King
East San Diego: Drs. Andreea Nastasoiu and Bob Meisel
El Cajon: Drs. Bruce Nguyen and Bob Meisel
San Marcos: Drs. Eric White and Doug Osborne
Together, the volunteers examined 115 students and prescribed 104 pairs of glasses, all of which will be fabricated by VSP.
These impactful efforts are already making a difference, enabling students to engage more fully in their studies and improving their potential for academic success.
Stay tuned for future volunteer opportunities—your support can change lives, one vision at a time!
Honoring Dr. Don Janiuk
This past month, we mourned the loss of a respected member of our San Diego optometric community, Dr. Janiuk. A passionate advocate for vision therapy, Dr. Janiuk dedicated his career to helping countless patients achieve better visual outcomes and inspiring colleagues with his expertise and compassion. His legacy will continue to shape the future of vision therapy and the lives of those he touched.
Donald Janiuk, O.D., FCOVD, was Past-President of COVD (now OVDRA). His quiet and committed contribution to Developmental Optometry will not be forgotten. Don was a 1972 graduate of the Southern California College of Optometry, and built a strong private optometric practice in Poway. He was an early adopter to electro-diagnostic testing. He served as President of COVD in 1995-1996. His solid presence in San Diego supported all of us in our commitment to optimal patient care.
Retina Corner
Double Trouble - Simultaneous Bilateral Rhegmatogenous Retinal Detachment
Dear SDCOS Friends,
It has been wonderful seeing some familiar faces at events around town and thank you to those who were able to attend our recent Open House event at the RCSD Hillcrest office. This month’s Retina Corner dovetails nicely with last month’s edition, in which I presented and discussed a case of bilateral macular holes.
A pseudophakic 80-year-old woman was referred to me emergently for a possible rhegmatogenous retinal detachment (RRD) in the right eye. Her uncorrected visual acuity was 20/400 OD and 20/30 OS. She described a progressive curtain coming from the inferior visual field in the right eye and no symptoms in the left eye.
Fundus examination and multimodal imaging (Figure 1) confirmed a macula-involving RRD OD with a causative superotemporal horseshoe tear. I dilated and performed a thorough examination of the fellow eye to be sure nothing was brewing, as is my practice with all new patients.
Examination of the fellow eye revealed what appeared to be subretinal fluid in the far superotemporal periphery (marked by yellow arrows in Figure 2A). Scleral depressed examination revealed two small flap tears in an area of localized retinal detachment consistent with simultaneous bilateral RRDs.
The patient was shocked at the diagnosis given her lack of symptoms in her left eye. It also led to a challenging discussion regarding her treatment options. In general, there are several treatment options for RRD including pneumatic retinopexy, scleral buckling, and pars plana vitrectomy with or without a scleral buckle. In an asymptomatic eye with a far peripheral detachment, a laser retinopexy or even very close observation may be considered under special circumstances in addition to the above options.
She felt strongly that she wanted to prioritize treatment of her right eye, which had suffered rapid visual deterioration. Given the absence of symptoms in her left eye, she was reluctant to undergo consecutive surgical repair.
After an extensive discussion, we agreed to a laser retinopexy OS and to proceed with pars plana vitrectomy with gas tamponade in the symptomatic OD. Same day laser retinopexy was performed in the office without complication and the laser was brought around the fluid from ora to ora assisted by scleral depression. Subsequently, an uneventful 25-gauge pars plana vitrectomy with a fluid-air exchange, endolaser treatment of retinal tears, and a C3F8 tamponade was performed OD.
At her last follow-up, she was recovering well from vitrectomy OD and the retina remained attached under gas (images degraded by gas). The laser retinopexy was setting nicely OS with some pigmentation visible in the area of the barricade and no extension of the subretinal fluid (partially seen in Figure 3, highlighted by green arrows). She will be watched closely for recurrence in either eye, and if there is any progression of fluid OS, she has agreed to surgical repair.
This case brings up several important aspects of RRD pathogenesis and management. Rhegmatogenous detachments are generally related to abnormally strong vitreoretinal adhesions which cause mechanical traction and induce retinal tears at the vitreous base during vitreous liquefaction and posterior vitreous detachment. Fortunately, retinal detachments are relatively rare, with an incidence of about 1 in 10,000 people annually or about a 1 in 300 risk over an individual’s lifetime. Certain factors such as a family history of RRD, ocular trauma, high myopia, and genetic disorders such as Marfan’s syndrome and Stickler’s syndrome increase one’s risk of developing a detachment. The risk of developing a retinal detachment in the fellow eye after presenting with an RRD is substantially higher than the risk of the general population, at approximately 10%. Overall, simultaneous bilateral retinal detachments are very rare, accounting for less than 1% of all patients presenting with a retinal detachment, and bring about specific challenges in management.
I hope that you enjoyed this month’s edition of Retina Corner. As always, if you have any questions or there is ever something I can help with, please feel free to contact me at any time.
Best wishes, and until next time,
Thomas
Thomas Lazzarini, MD
Retina Consultants San Diego
626-537-5857 (cell)
lazzarini@rcsd.com
Shaping Your Plans for a Successful Future
This article provides information about certain objectives business owners should set to begin shaping a plan for their business futures. When we talk about planning for the future, we often talk creating a plan. The idea of creating something as big as a plan for the future can imply a ton of from-scratch work (as is often the case), which can cause you to want to put that ton of work off to another day. As a successful (and likely busy) owner, you may not think you have time to create a plan. However, there’s good news, because when it comes to planning for a successful future, it’s more a matter of shaping than creating.
Shaping a Plan vs. Creating a Plan
You understand how much work creation requires. You created your business, its processes, and most of the aspects that make the business successful. As you age and approach the next stage in your business life, you may not want to put that kind of work into a plan for the future. How, then, can you avoid the feeling of helplessness that can come from knowing you have something big to do and either no drive or guide to pursue it? The key is to reframe creating as shaping. This isn’t merely a semantic trick. You likely have a general idea for what you want your future to look like, even if you don’t have a formal plan. For example, you may have an idea for when you want to be out of your business. You might have a preference for who will take over once you exit. You might have desires for what you will do with all the money you’ll have from successfully selling or transferring your business. The ideas are there. They simply don’t have any shape. How can you give these nebulous but high-potential ideas shape? It all starts by collecting data and setting strategy. Collecting Data and Setting Strategy:
Step 1 in Shaping a Plan
Planning cannot truly begin unless you know what you want and need. For example, can you confidently say exactly how much money you’d need to one day exit your business with financial security? Do you know what it would take for your family to continue living their current lifestyles if you chose to never exit your business or, worse, were forced from your business (by death, incapacitation, or otherwise)? These are big, introspective questions that have real, often negative consequences if left unanswered. How can you approach them and still successfully run your business? A good way to begin shaping your plans is to collect data and set a strategy. To do this, you should start by establishing a few objectives.
ESTABLISHING OBJECTIVES
Though there are many facets to a successful plan, there are three overarching objectives that you should establish. Without knowing these three objectives, it’s nearly impossible to shape a successful plan for the future.
1. The Foundational Goal – Financial Protection: Absolutely no plan for the future can ever be considered successful unless it achieves financial protection for you and your family members. Your financial protection goal is unique, so avoid temptations to compare what would make you financially confident with what makes others financially confident. You should determine what it takes to achieve financial protection first and foremost.
2. Universal Goals – When, for How Much, and to Whom: Given all the work you’ve put into building your business, you’ll likely want a say in when you eventually leave or transfer your business, how much you get for your business, and to whom you leave your business. Once you begin to think about these wants, you may find that you want solutions to the questions these wants create, such as “How can I get the money I need?” and “Why do I want to transfer my business to this person?” Determining universal goals takes your nebulous ideas and shapes them into actionable goals.
3. Values-Based Goals – Keeping Principles Intact: A common stumbling block for owners is uncovering their values-based goals. These goals are basically living principles. For example, you might want your company to remain in your community after you sell or transfer it. For many owners, this desire can be so strong that they’ll gladly take less than top dollar (but still achieve financial security) to see it through. Unfortunately, many owners don’t realize how important their values are until the moment it’s time to exit, at which point, it’s often too late to do anything about it without throwing the entire plan into chaos. Though this part of data collection is equal parts art and science, it’s important for you to uncover and address your values-based goals early.
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. Park Avenue Securities LLC (PAS) is a wholly-owned subsidiary of The Guardian Life Insurance Company of America (Guardian). PAS is a registered broker-dealer offering investment products, as well as a registered investment adviser offering financial planning and investment advisory services. PAS is a member of FINRA and SIPC. Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Please consult your tax, legal, or accounting professional regarding your individual circumstances.
Registered Representative and Financial Advisor 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. | CA Insurance License #0D97541 | 7919911.1 Exp. 05/27
Read Newsletters
Learn More
Events
Contact Us
© 2025 The San Diego County Optometric Society. All rights Reserved. Accessibility Statement - Privacy Policy - Sitemap
Powered by:
