Laser induced damage to optical coatings is generally a localized phenomenon associated with coating defects. The most common of the defect types are the well-known nodule defect. This paper reviews the use of experiments and modeling to understand the formation of these defects and their interaction with laser light. Of particular interest are efforts to identify which defects are most susceptible to laser damage. Also discussed are possible methods for stabilizing these defects (laser conditioning) or preventing their initiation (source stabilization, spatter particle trapping).