Graduate Union Life Member and Associate Professor Anne Brooks is Head of Special Clinic 3 at The Royal Victorian Eye and Ear Hospital (Eye and Ear), as well as Clinical Lead, Acute Ophthalmology Service, Ophthalmologist to the Glaucoma Investigation and Research Unit and Ophthalmologist to the Surgical Ophthalmology Service at the Eye and Ear. She is Chair of the Melbourne Ophthalmic Alumni and Fellow of the Melbourne Medical School Academy of Clinical Teachers.
One particular area of focus for her is glaucoma. Professor Brooks serves on many committees including Chair of The Australian and New Zealand Glaucoma Interest Group of the Royal Australian and New Zealand College of Ophthalmologists. As Professor Brooks stated later in the interview, glaucoma is an affliction that affects 1 in 8 Australians over 80. In many cases, medical treatment, laser treatment or surgery can slow or halt the progress of glaucoma but any vision loss cannot be restored. Her work and commitment is therefore crucial in assisting glaucoma sufferers and advancing the field of knowledge for treatment.
Professor Brooks shares with Members her tertiary pathway, work in ophthalmology and, in particular, her experience in treating glaucoma patients.
What spurred you to select a degree in medicine and later in ophthalmology?
I began an Arts Degree at The University of Melbourne (French, Indonesian and Malayan Studies and Biology) with Music – clarinet (I have my LMusA clarinet performing) but realised that I would be able to help people in a very real practical way in medicine and help the community.
Ophthalmology is a great speciality. My mother, the late Dr Nancy Lewis, was very enthusiastic and ground breaking, being one of the first female ophthalmologists and establishing the Eye Clinic at the Royal Children’s Hospital. She was a wonderful role model for me and I could see the enjoyment and fulfilment that a career in ophthalmology brought her.
What in your view, is the most notable research you’ve conducted?
Research with the late Dr Bill Gillies OAM, who was an exceptional mentor. I carried out research particularly in glaucoma and associated iris and corneal changes. My PhD entitled “Investigations into Corneal Abnormalities” shed further light on the secondary glaucomas. My research has contributed to, and advanced knowledge of the secondary glaucomas and corneal changes in glaucoma.
What were the most important things that you learned during your first internship and subsequent residency?
I was fortunate enough to work with Dr John Penington and Associate Professor Peter Greenberg OAM, who reinforced during my upbringing that communication and treating patients in a holistic manner is of utmost importance. I learnt the importance of perseverance and persistence to achieve realistic goals. From working with Professor Priscilla Kincaid-Smith AC CBE, I learnt that women can achieve anything.
What are some of the misconceptions of glaucoma? Who is most at risk and what are the various forms of glaucoma? Are there preventative measures?
Some common misconceptions of glaucoma include: “glaucoma won’t happen to me” and “glaucoma causes a painful eye”. Mostly glaucoma is the “sneak thief of sight” and there is gradual insidious visual loss, particularly of side vision, so that it is not noticed until permanent damage has been caused.
The main risk factors for glaucoma include advancing age, family history, high intraocular pressure, African, Asian or Inuit ethnicity, refractive error, thinner corneas, Type 2 diabetes, prolonged steroid use, migraine and peripheral vasospasm, as well as previous eye trauma.
There are various forms of glaucoma including: Chronic – “the sneak thief of sight” which is usually open angle, and may be primary or secondary. There is also an Acute form, which is usually painful and usually with a closed angle. It is important to undergo regular eye examinations, particularly from 40 years of age, by an eye health professional, especially if there are risk factors. Have a baseline examination and follow up as advised. It’s important to get a referral to an ophthalmologist if abnormalities are detected. My work on the early detection of glaucoma was with a very early Scanning Laser Ophthalmoscope in conjunction with Professors Tony Klein AM and Keith Nugent in the Department of Physics at The University of Melbourne.
It was published in 1995 and demonstrated that this technology would be very exciting and important in the future. This has been the case, and Scanning Laser Ophthalmoscopy has now become a routine clinical investigation.
What is the state of glaucoma like in Australia?
In Australia approximately 300,000 people have glaucoma: 1 in 8 Australians over 80 will develop glaucoma. First degree relatives of glaucoma patients have an 8-fold increased risk of developing glaucoma. At present, 50 percent of people with glaucoma in Australia remain undiagnosed. The incidence of glaucoma is increasing very rapidly with the ageing population. The good news is that once diagnosed, glaucoma is treatable and the patient support group, Glaucoma Australia, is very helpful in further educating and providing support and resources for patients and their families with glaucoma.
Do you see the need for change to the current medical system to better assist those needing eye care?
Yes, there needs to be adequate access to affordable eye care, particularly for patients with chronic eye disease such as glaucoma who require long term follow-up. This also applies to other eye conditions such as patients with diabetic eye disease, many of whom have delayed access to eye care.
What should we be doing to maintain, or at least try to maintain healthy eyes?
It is important to maintain good general health, exercise, have a balanced diet with leafy green vegetables, fruit and fish, wear sun protection including sunglasses outside, wear protective eye wear in dangerous situations such as hammering metal on metal, and not to smoke. It is also important to have regular eye checks with an eye health professional, particularly over the age of 40.
What is most stimulating about your specialisation?
The most stimulating aspect of my speciality is when people regain their sight as a result of surgery which I have performed, particularly cataract surgery. It is also very rewarding to treat and retain sight in patients with glaucoma in the long term.
What do you know now that would have been useful before?
Insight into people’s behaviour, and the social and emotional issues which affect their physical condition.
What are your steps for the future?
I wish to continue clinical care of patients, and in particular, to continue my teaching role which includes undergraduate and postgraduate medical students, RANZCO trainees and fellows, overseas trained medical graduates and GPs.
You were recently awarded the Board Chair’s Medal at the Eye and Ear’s annual staff Excellence Awards. How do you feel having received this prestigious award?
I am very honoured to have received this award and grateful for all the people who have helped me over the years. I am thankful for this recognition.