BREVARD COUTNY, FLORIDA – When Dr. William Broussard started his ophthalmology practice in Melbourne in 1967, no one was taking emergency calls at night in all of Brevard County. To him, that didn’t square with the commitment required of doctors.

“Part of your oath was you were going to take care of people. This did not relate to what time of day it was, what day of the week, or whether it was a holiday. You took care of them when they needed it,” Broussard said.

So he placed himself on call, seven days a week, 365 days a year. For three years.

His career evolution is testimony to the observation that the more things change, the more they remain the same: Today, Broussard splits his time between seeing patients and maintaining his Osceola County ranch.

“I really work seven days a week,” he said, though clearly, both vocations are labors of love.

In addition to tending cattle at the Crescent J Ranch, Broussard spends time at Forever Florida, the adjacent 3,200-acre nature preserve he and wife Margaret founded in honor of their son. Wildlife ecologist Allen Broussard died in 1990 at the age of 29, after fighting Hodgkin’s disease.

“The reason why it’s there is he asked me to do it,” Broussard said of Forever Florida and conversations he had with his son during the final months of his life. “That’s keeping a promise.”

Crescent J carries out a conservationist mission, as well. The ranch raises Spanish Colonial, or Cracker, cattle in an effort to preserve the line. Spanish Colonial cattle are descendants of cattle brought to America by the conquistadors.

The ranch also boasts a herd of Cracker horses, another endangered breed that Broussard is working to save.

Growing Family, Practice

Broussard, who comes from a Louisiana ranching family, wasted no time acquiring the ranch. The couple moved to Florida in 1967, after Broussard completed military service in Germany, and bought the ranch in 1969.

They had four children when they arrived and bought a four-bedroom, two-bath home for $29,000. Broussard even remembers the monthly payment – $198, including taxes and insurance.

They lived there a few years, then built a two-story home in Satellite Beach, Florida in 1973. “We built that thinking, my gosh, we’ll never outgrow that. But we did,” he said.

His medical practice was on its way to outgrowing its space across from the hospital as well. After only two or three months in Melbourne, his schedule was booked solid six months out.

After three years, he invited a doctor he’d met while both were in residency at Letterman Army Hospital in San Francisco to join him in practice. Suddenly, he was on call only every other night.

The name of the business evolved with the growth, from William A. Broussard, M.D. P.A. to Melbourne Eye Associates, and finally to Florida Eye Associates, to reflect the practice’s offices in other Brevard communities.

The practice operates an ambulatory surgery center and office in Melbourne, as well as offices in Cocoa Beach, Viera and Palm Bay. A Port St. John location is on the way.

By the time Florida Eye Associates had grown to include five doctors, it was time for a larger main office. Broussard was interested in a building in Downtown Melbourne that had become available as a result of the savings and loan crisis. He offered $500,000 for the building but was told it had to be sold at a public auction.

“So we bought it at public auction for $350,000,” Broussard said with a smile. “That was their minimum bid. We thought there would be a bidding war, and we were ready to go to $600,000.”

Florida Eye Associates moved to the building, at U.S. 192 and Hickory Street, in 1993. Subsequent expansions have kept up with the growth of the practice, which now includes 12 doctors and 117 employees.

Subspecialties have taken up much of the major surgeries in ophthalmology. Before that, Broussard performed Brevard’s first retinal detachment repair, corneal transplant and surgery on a child to correct crossed eyes.

President of HRMC Medical Staff

Two of the couple’s three daughters followed in their father’s footsteps and chose a medical career. Dianne studied neurophysiology, runs a lab and teaches at the University of Toronto medical school and Laura is an RN in Denver. Daughter Lynn worked in and then left a career as a CPA to run a counseling service.

Entwined with Broussard’s career has been the growth of what’s now Holmes Regional Medical Center. Broussard started his practice in an office across from the hospital’s current location, where it moved in 1962. At the time, it was called Brevard Hospital.

Those were the days before specialists in emergency medicine, so all specialties were required to take turns covering the ER. If, for example, a pathologist was working the ER when an eye case came in, Broussard would get called in. “It happened all the time,” he said.

When he served as president of the hospital medical staff, Broussard pushed for a better system. The hospital got interested, and eventually local physicians pursued specialties in emergency medicine. Today, specialists in emergency medicine staff the ER.

Broussard served as president of the staff an unprecedented four times, and pushed to extend the term of the position from one year to two. “In one year, you just really learn the ropes. In two years, you can get something done,” he said.

Great Brevard ‘Smoke Out’

Among his proudest accomplishments is getting cigarettes out of the hospital. “Everybody smoked,” Broussard said. “Doctors smoked, the patients smoked, nurses smoked.”

The effort was accomplished in smaller steps: No smoking during staff meetings; Cigarettes were removed from the gift shop (the excuse was that they raised money for the volunteer program); and no smoking by nurses and patients.

Today, there’s no smoking on the entire hospital grounds, or any other Brevard County hospitals.

Broussard’s was one of the first doctor offices to prohibit smoking in the waiting room. “Some patients were very irritated by that,” Broussard said.

He remembers one patient who was told to put out his cigarette, and he threw the butt into the aquarium. As if he needed proof of the health effects, all the fish died.

Conservationist

Just as Broussard was convinced of the ill effects of smoking, he fears the consequences of the rapid development and land use issues he’s seen in Brevard.

“We have to have vision that includes: When do we stop this? There have to be significant amounts of land that are untouchable. You must protect water, protect wildlife. We don’t take care of anything until a building blows up. That’s the way we are,” he said.

Drawing water from the St. John’s River, as has been proposed, would be suicide, he said. The north end will become polluted, water will stop moving and saltwater will intrude further on the water system.

Conservation is a better approach, but Central Floridians have little motivation to use less water. “As long as it’s too cheap, it’s going to be wasted. People’s general attitude is, ‘If I can afford it, I can waste it,’” Broussard said.

He disconnected the irrigation system at his Riverside Drive home north of Indialantic more than 10 years ago, and landscapes with native plants.

Investing In People

In his practice, Broussard continues to live by the oath he took to help. He led by example in volunteering with the Brevard Health Alliance, the county’s health clinic, and many Florida Eye Associates physicians do the same.

“If a patient with complicated needs is referred to Miami and doesn’t have transportation, “we’ll take him there,” Broussard said.

He sees such generosity as an investment in people, and as building bonds that will yield loyal patients in the future. “In my opinion, you come out ahead doing that,” he said.

At 76 years old, Broussard plans to continue serving as president and CEO of the company as long as he can. Expect him to take the same approach to work at the ranch.

“I like the balance,” he said.

This article provided by Space Coast Medicine: Dr. Broussard Pioneered Eye Care In Brevard

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Diabetic Retinopathy – An Overview
by Ralph Paylor, MD

Diabetic retinopathy is an ocular complication of diabetes. It affects about one half of the Americans diagnosed with diabetes and can lead to blindness if undetected or untreated. Because diabetic retinopathy can damage your sight without obvious symptoms, diabetics should have a dilated eye examination at least once a year.

Diabetes can cause damage to tiny blood vessels including those of the retina, the light-sensitive tissue at the back of the eye. While retinal blood vessels are being damaged, most people do not notice any changes in their eye or their vision. Sometimes, the blood vessels leak fluids onto the macula which is the portion of the retina responsible for seeing fine detail. When this happens, the fluid makes the macula swell, resulting in blurred vision.

As the disease progresses, new blood vessels grow along the retina and in the vitreous gel of the eye. Without treatment, these blood vessels can swell, bleed and ultimately destroy the retina.

A dilated eye examination allows your doctor to look at the back of the eye and check your retina for early signs of the disease, such as: changes in blood vessels; retinal swelling, such as macular edema; pale, fatty deposits on the retina; or damaged nerve tissue.

If your doctor suspects that you need treatment for macular edema, he or she may ask you to have a test called fluorescein angiography. Dye is injected into your arm. Pictures are then taken as the dye passes through the blood vessels in the retina. This test allows your doctor to locate the leaking blood vessels.

There are two treatments for diabetic retinopathy. They are very effective in reducing vision loss from this disease. In fact, even people with advanced retinopathy have a 90 percent chance of keeping their vision when they get treatment before the retina is severely damaged. It is important to note that although treatment is very successful, there is no cure for diabetic retinopathy.

Laser photocoagulation is performed in a doctor’s office or eye clinic. Before the surgery, your ophthalmologist will dilate your pupil and apply numbing drops. The doctor also may numb the area behind the eye to prevent any discomfort.

The lights will be dim. As you sit facing the laser, your doctor will hold a special lens to your eye. During the procedure, you may see flashes of light. For the rest of the day, your vision will probably be a little blurry.

Instead of laser surgery, you may need an operation called a vitrectomy to restore your sight. A vitrectomy is performed if you have a lot of blood in the vitreous. It involves removing the cloudy vitreous and replacing it with a salt solution. Because the vitreous is mostly water, you will notice no change between the salt solution and the normal vitreous.

Early vitrectomy is especially effective in people with insulin-dependent diabetes, who may be at greater risk of blindness from a hemorrhage into the eye.

Vitrectomy is often done under local anesthesia. This means that you will be awake during the operation. The doctor makes a tiny incision in the sclera, or white of the eye. Next, a small instrument is placed into the eye. It removes the vitreous and inserts the salt solution into the eye.

Diabetes is a serious threat to sight and should be taken very seriously. Early detection and treatment is critical to ocular health, but good management of diabetes is the best prevention. Researchers have found that diabetic patients who are able to maintain appropriate blood sugar levels have fewer eye problems than those with poor control. Diet and exercise also play important roles in the overall health of those with diabetes.

Florida Eye Associates, founded in 1967 is the area’s leading provider of ophthalmology services. For information and appointments, call 321-392-4322.

Understanding Cataracts
by Tracy Ravin, MD

Cataracts are a leading cause of curable blindness worldwide. In the , no one should go blind from cataracts with proper care of an ophthalmologist. Formation of a cataract is a normal aging process of the lens inside the eye. The lens is the part of the eye that helps focus light rays on the retina (the back layer of the eye). Early in life, the lens is transparent and lets the light pass through; with time the lens becomes cloudy and then is called a cataract. When the cataract gets cloudy enough to interfere with a persons’ vision, cataract surgery should be considered. This article will address common questions people have about cataracts.

What Causes Cataracts?

In most cases, the answer is age. Cataracts form slowly and cause no pain. Rarely, babies can be born with a cloudy lens called a congenital cataract. Some things that speed the development of cataracts include: long-term use of corticosteroids, alcoholism, diabetes mellitus, eye injury, smoking, and long-time exposure to ultra-violet (UV) light.

How Will I Know If I Have a Cataract?

Many people have cataracts without knowing it. This is because in the early stages the cataract does not interfere with vision. As the lens gets thicker, it has more power within the eye which can actually improve reading vision, sometimes called “second sight.” With time, the lens becomes cloudier and may cause a gradual blurring of vision. This is often noticed as a difficulty reading road signs when driving. Night driving can also be affected. Haloes around lights are often seen. Sensitivity to bright light or decreased vision in bright light are common complaints. Ability to distinguish or perceive colors may be impaired.

How Are Cataracts Treated?

For early stage cataract, changing glasses prescription may improve vision. There are no medications or eye-drops that will help. When cataracts are interfering with normal activities of daily living, surgery should be considered.

Florida Eye Associates’ surgeons usually remove cataracts under local anesthesia in our ambulatory surgery center. The surgeon makes a tiny incision and the clouded lens is removed through “phacoemulsification,” a process that uses ultrasound power to liquefy the lens so it can be withdrawn. A clear lens implant is then placed in the sac that used to hold the cataract.

The power of the lens implant is adjusted according to measurements taken before surgery. With the proper lens implant, sometimes the need for glasses can be eliminated. A common misconception that lasers are used in cataract surgery is not true, although laser treatment may be done at some point after cataract surgery. Cataract surgery is covered by insurance and Medicare.

How Long Is Recovery from Surgery?

Patients go home the same day after cataract surgery. Most patients have no pain, only a scratchy or sandy feeling in the eye. Most people return to their normal activities within a day or two after surgery. Eye drops are used after surgery and avoiding heavy lifting or rubbing of the operated eye are recommended. Other instructions depend on the physician’s preferences.

Can Cataracts Come Back?

No. Once removed, cataracts cannot grow back. Sometimes a film can grow behind the lens implant and cause cloudy vision to return. This membrane can be removed with a laser and does not grow back.

Tracy Ravin, MD is a comprehensive ophthalmologist with Florida Eye Associates. She is accepting new patients at her offices in Melbourne and Cocoa Beach and can be reached at 321-392-4322

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