Northwest Health Fall 2012

Q&A With Dr. Michael Brush

Ophthalmologist Michael Brush, MD, sees progress in treatments for eye diseases.

Go to: Northwest Health Index

Many people need vision correction for near or farsightedness. But what other eye conditions should we be concerned about?
The four most common conditions are glaucoma, cataracts, macular degeneration, and damage caused by diabetes. The first three — especially cataracts and macular degeneration — are age related. Glaucoma also has some genetic and racial components.

What's the treatment for cataracts?
Surgery, where the cloudy natural lens is replaced with an artificial lens. There's a 98 percent chance that you will see better after this surgery. In the last five years,  I've seen younger patients — in their late 60s — having this surgery. Patients recognize that it's quite effective, and the pros of doing it earlier outweigh the cons.

And what about glaucoma?
Once you have glaucoma, a condition related to elevated eye pressure, it doesn't go away. It can be symptomless until it causes vision loss, but can be detected during regular eye exams before it causes vision loss. The treatment is to lower eye pressure, usually by using medication in the form of prescription eye drops.

I've heard there is a new treatment for macular degeneration. Is that true?
This condition, which primarily affects older adults, damages the retina. Patients lose the central part of their vision, and sometimes become blind. This disease has two variations — "dry" and "wet."  The main treatment for the more common dry form involves taking specific vitamins that can slow the progress of the disease. For the wet form of this disease, there are new drugs that can stop vision loss, and in some cases, restore vision.

You said that diabetes is another problem for eye health. Why is this?
Diabetes damages blood vessels throughout your body, including in your eye. At Group Health Medical Centers, we have a strong program to make sure our patients with diabetes are screened for diabetic eye disease. If you have diabetes, work with your primary care doctor to control your blood sugars, as better control in the long run will help prevent damage to the eye that can cause vision loss.

Is there any patient behavior you wish you could change?
Patients with glaucoma need to put drops in their eyes a couple of times a day. It can be a challenge, and patients don't always use them consistently. With a progressive disease like glaucoma, that consistency is very important.

You became a Group Health physician several years ago. What do you like about practicing here?
The relationship between the optometrist — the provider you see for regular eye exams and eyeglass prescriptions — and the ophthalmologist is very close. We can easily communicate back and forth. If an optometrist wants me to consult on a patient, we can often do that virtually. It can save the patient from having to come in. Being part of a health care system where all care providers have access to the same information about a patient is unusual, and helps us provide better care.

What should we be doing to protect our eyes?
Use common sense precautions. Wear sunglasses when you're outdoors. Use eye protection, such as goggles, for sports and work situations when you can.

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