President's Message

Dear Members,

As we head into October, I want to take a moment to thank everyone who joined us for our September CE event. It was a huge success! We were fortunate to have our ophthalmology friends share an excellent presentation on glaucoma and corneal dystrophies. The evening was a great reminder of how valuable it is to come together, learn from one another, and strengthen the relationships within our eye care community.

Many of us are also getting ready for the AAO conference in Anaheim! It is bound to be an eventful weekend filled with education, new ideas, and, of course, reconnecting with friends and colleagues. I hope to see many familiar SDCOS faces there!

Closer to home, our next OD Social is coming up on October 25th! Join us for a Pickleball Tournament at Mission Bay Resort from 3:00–5:00 PM. Whether you are a seasoned pickleball player or have never picked up a paddle, come out for a fun afternoon with your fellow ODs. Keep an eye out for the QR code to register!

And now for the event we are especially excited about: the SDCOS Holiday Party! Mark your calendars for Friday, December 4th, at Del Mar Social, because this year’s celebration is going to be one to remember. Our theme is PROM!

That’s right—we are bringing back the excitement, nostalgia, and fun of prom night! Break out your best formalwear, channel your favorite prom-era style, and get ready for an evening filled with great food, drinks, music, dancing, and plenty of opportunities to celebrate with your SDCOS colleagues. Whether you are reliving your high school glory days or creating the prom experience you always wanted, this is a party you will not want to miss.

We encourage everyone to start planning their look and invite your friends and colleagues to join in the fun. Tickets will be going live shortly, so stay tuned for registration details and be sure to reserve your spot as soon as they become available. We cannot wait to see everyone dressed up and celebrating together!

As always, thank you for being part of SDCOS and for continuing to make our optometric community such a connected and supportive one. I look forward to seeing many of you throughout the fall—and especially at our PROM-themed Holiday Party in December!

Your president,

Sloan Rajadhyksha OD, FAAO, FCOVD

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Volunteer Opportunity: Give Back this Fall and Beyond

There are several meaningful opportunities for SDCOS members to volunteer their time and expertise this season. Whether you are passionate about serving veterans, supporting underserved youth, or providing care across the border, there is a place for you.
 

San Diego State Flying Samaritans: Volunteer ODs are needed for two upcoming clinic dates in Tijuana:

• November 15
• December 6

Spanish fluency is not required. If you are interested in joining this team for either date, please reach out.

North County Stand Down for Veterans The North County Stand Down will be held November 19-21 at Felicita Park in Escondido, 9am to 4pm daily. ODs and opticians are needed all three days to provide eye care services to our local veteran community. This is a high-impact event and every volunteer makes a difference. For more information, visit https://ncstanddown.org/

 

LOVC La Mesa-Spring Valley Vision Screenings The LOVC initiative with the La Mesa Spring Valley School District is underway, with portable vision clinics already running at Title 1 schools in late September and early October. This program brings essential vision screenings and care directly to students who need it most.

Volunteers are needed to join Dr. Eric White or Dr. Bob Meisel for the remaining school year dates. Here is what is still available:

1 OD needed:

• October 23: La Mesa Dale
• December 4: Highlands
• February 5: Spring Valley Academy
• February 19: Bancroft
• April 16: Sweetwater Springs

2 ODs needed:

• January 8: Rancho
• February 26: STEAM
• March 5: Maryland Avenue
• April 16: 

If you can commit to any of these dates, please contact Michael Brandenburg at mbrandenburg@cox.net. For any questions, contact Dr. Bob Meisel at rmeisel47@gmail.com.. No date is too far out to sign up now. These clinics fill up and the kids are counting on us!

OD Relations Liaison Message

Please contact Dr. Lucia Millet, OD, Society Optometrist Relations Liaison at sdcos@gmail.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. 

Let's Play Pickleball!

Join fellow SDCOS members at Mission Bay Resort for a Pickleball Social on Sunday, October 25, 2026, from 3-5 PM! Open and guided play for all skill levels, followed by food and drinks at the resort. Grab your colleagues, bring your energy, and enjoy an afternoon of pickleball, networking, and friendly competition.

Spots are limited, so RSVP early to reserve your place on the court! Scan the QR code or RSVP here.

Questions? Contact Hunter Morgan at 304-677-3776 or huntermorganod@gmail.com.

SDCOS Annual Holiday Party: Prom Night!

Remember the anticipation of prom night? The outfit, the music, the magic of a night that felt like anything could happen? This December, we're bringing it all back.

Whether you're reliving your glory days or finally getting the prom experience you deserved, this is your night. Trade your white coat or scrubs for something a little more fabulous and join your fellow SDCOS members for an unforgettable evening.
 

• Date: Friday, December 4, 2026 at 6:00 PM
• Venue: Del Mar Social, Del Mar, CA
• Tickets: $75/person (members) | $90/person (non-members)
• Includes: Open bar, Mediterranean feast with vegetarian and vegan options, and a Speakeasy hidden bar experience

Your corsage is optional. Your presence is not.

Scan the QR code or RSVP here.

Cataract Corner

For the Co-Managing Optometrist: Diagnosis, Referral Timing, and Post-Op Care in 2026.

Shiloh Simons,DO
San Diego Eye and Laser
Nvision Eye Centers

Dear Colleagues,

Cataract remains the #1 cause of referral to our offices. With advanced technology IOLs and managed care changes, the referral pathway has changed. Here is a practical update for diagnosis, when to refer, and how we can best co-manage for our mutual patients.

Diagnosis, Documenting Beyond "2+ NS"

Payers and surgeons need more than grading. For a referral that gets approved quickly, include:

A. Visual Function:

·       BCVA at distance and near, with and without glare (BAT or Brightness Acuity Tester)

·       Pinhole VA, if no improvement, document macular pathology concern

·       Contrast sensitivity complaint: "difficulty night driving, glare from oncoming headlights"

B. Slit Lamp Findings to Document:

·       Type: Nuclear sclerotic, cortical (spokes), posterior subcapsular (PSC, most visually significant)

·       Grade: Use LOCS III or simple 1–4 scale, but always note PSC presence even if 1+

·       Functional impact: "PSC 2+ encroaching visual axis 3mm zone"

C. The Pre-Referral Rule-Outs:

Before you refer, document you have ruled out:

1.     Uncorrected refractive error / dry eye / film, do a refraction and note TBUT

2.     Macular pathology, macula OCT is now performed pre-op for each cataract referral

3.     Corneal pathology, topography is also performed in all cataract referrals at the pre-op

Pearl: A patient with 20/25 and a 1+ PSC complaining of severe glare is a better surgical candidate than 20/50 NS 2+ who sees fine. Documenting the functional complaint is always helpful for the doctors, patients, and their payers.

When to Refer, The 20/40 Myth

We no longer need to wait for 20/40. Refer when:

·       Functional visual disability: Night driving difficulty, loss of stereopsis, occupational needs, monocular diplopia

·       Medical indication: Lens-induced phacomorphic angle closure, phacolytic glaucoma, or dense cataract preventing fundus view in a diabetic patient who needs retinal monitoring

·       Anisometropia after first eye: If the patient had the first eye done, the second eye often qualifies sooner

Document: "Patient reports difficulty performing ADLs despite optimal correction secondary to lens opacity", this language supports medical necessity.

Referrals, Including Direct to Ophthalmology on Some Managed Care Plans

This is the biggest change for 2026.

For most PPOs / Medicare:

·       Send to us; we will see for cataract evaluation and schedule.

For Managed Care, SCMG and similar IPAs:

Many of you have patients on Sharp Community Medical Group (SCMG), SCMG Graybill, and other capitation plans. For cataract, SCMG now allows direct referral from Optometry to Ophthalmology for cataract evaluation without a PCP referral if you use the correct pathway.

How to do it:

1.     In your EMR, use referral diagnosis: H25.10 Age-related cataract, unspecified, or specific H25.11, H25.12, H25.13

2.     Refer directly to: NVISION Eye Centers / Ophthalmology, Cataract. Tax ID and NPI will auto-populate in Epic/Cerner. Our team will handle other records and payers.

3.     Include: BCVA, refraction, slit lamp grade, OCT macula, and note "Direct Optometry to Ophthalmology per SCMG cataract pathway, no PCP auth required"

4.     For SCMG: attach the SCMG Vision Referral Form and mark "Medical, Cataract," not routine

This avoids the 3-week PCP loop and gets the patient seen in 5–7 days. If you get a denial for "needs PCP referral," call our referral team, we have an SCMG liaison who will override.

Pre-Op, What We Need From You

Once you refer, please send:

·       The last 2 refractions (to show myopic shift), if available

·       Corneal topography / OCT will be done at every pre-op, but baselines are always helpful, as are visual fields if glaucoma co-management is involved

·       List of systemic meds, especially Flomax (Tamsulosin), anticoagulants, and diabetic meds, especially GLP-1 agents (these patients will need to fast with clear liquids 24 hours before anesthesia, or stop GLP-1s one week before surgery)

·       Treat dry eye aggressively pre-op, we may postpone surgery for SPK

Post-Op Care, Co-Management Protocol

We follow standard co-management and return patients to you at 1 week or 1 month per your comfort.

Our standard post-op drops (unless you prefer your own):

·       Day 1–7: Ofloxacin QID + Prednisolone QID + Ketorolac QID

·       Week 2–4: Prednisolone taper

·       We also offer post-op kits with a combination product that can be tapered over 3 weeks

What you should see at each visit:

POD1 (we see):

·       VA usually 20/40–20/25

·       Cornea mild edema

·       AC cell 1+ normal

·       IOP check critical, steroid responder

POW1 (you see, Day 5–10):

·       VA should be 20/30 or better

·       Check IOP (must be less than 21)

·       Cornea clear, wound sealed (Seidel negative)

·       AC quieting, IOL centered

·       Red flags to send back same day: IOP >30, VA drop >2 lines from POD1, fibrin in AC, wound leak, severe pain

POM1 (you see, Week 3–4):

·       Final refraction; check for CME with OCT if VA not 20/25+ (incidence 1–2%, treat with prolonged NSAID)

·       Posterior capsule opacity counseling, YAG later if needed

·       Resume glaucoma drops if held

Billing:

·       Use 66984 co-management modifier 55 (we bill 54)

·       For SCMG, co-management is included, no separate billing needed, just send notes

Final Pearl: The PSC Patient

If you see a 52-year-old diabetic with 20/25 and a small PSC, do not wait. PSC progresses fast and will be 20/80 in 6 months. That is the patient who will thank you most for early referral.

We value your partnership. Our referral team is at 858-278-9900 or the direct SCMG line. Shiloh.Simons@nvisioncenters.com

We always appreciate your final refraction data for our outcomes tracking and any feedback you or your patients have.

Shiloh Simons, DO FACOO 
San Diego Eye & Laser / An NVISION Eye Center 8010 Frost St, Suite 510, San Diego, CA

SDCOS Board of Directors

Welcome New SDCOS Members!

We’re excited to welcome our newest members to the San Diego County Optometric Society!

Your decision to join our local community of optometrists reflects a shared commitment to advancing patient care, supporting one another, and staying connected in our ever-evolving profession.

SDCOS offers opportunities to grow both professionally and personally through continuing education, networking events, leadership involvement, and community outreach. Whether you’re new to the area or newly licensed, we’re glad you’re here.

We encourage you to get involved, attend upcoming events, and connect with fellow members. If you see a familiar face, say hello; and if not, introduce yourself. We’re a welcoming group!

We look forward to getting to know you and supporting you in your optometric journey.

Welcome to SDCOS!

Viet Nguyen
Lawrence Kazzazi

SDCOS Member Spotlight: Dr. Alla Young

We're thrilled to feature Dr. Alla Young in this month's Member Spotlight!

Dr. Young practices as a corporate sublease and medical optometrist at a co/omb practice. A graduate of the Illinois College of Optometry, Class of 2016, she has built her career around the kind of care that keeps patients coming back.

Her favorite part of the job is building relationships with returning patients, the continuity and trust that develops over time at the heart of what she loves most about optometry.

If she weren't an OD, she'd be a sportscaster. We'd tune in!

The last book she read was Project Hail Mary. A great pick for anyone who loves a story that keeps you guessing.

When she's not in the exam room, Dr. Young loves exploring San Diego's restaurant scene, always on the hunt for the next great meal.

Her advice to her younger self: Start retirement accounts early. Practical, honest, and something we all needed to hear sooner.

Thank you, Dr. Young, for sharing your story with the SDCOS community!

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