360º Medicine. A day at Dr Monés’s surgery
Jordi Monés (MD, PhD, ophthalmologist and macula and vitreous specialist) is a living example of the co-existence between medical vocation, commitment to research and empathy with those with vision problems. A day at the Institut de la Màcula combines these three elements
Each day, Dr Jordi Monés arrives at the surgery by bicycle after traversing nearly 20km. “It’s the best way of getting going and starting the day”, he says.
Among the patients in his charge today is a 68-year-old woman with exudative AMD. Having now lost 60% of her eyesight, the purpose of her visit is to apply the treatment again and keep her vision at the maximum level possible. “When I tell her that she won’t end up blind, she breathes a sigh of relief. It is one of the biggest fears for anyone”. Shortly afterwards, another patient with the same disease who has managed to halt its progress asks whether she can now stop attending the surgery. “Some people want to interrupt the treatment when they believe that they are not losing their sight any more. I have to explain to them that this is a chronic disease, one that never disappears, and that they can’t drop their guard”.
The morning’s final visit is a young man who suffers from Stargardt’s disease. At university age and with a whole life to construct, he has to “address a disease that will affect his studies as he is now going to find it difficult to read. This is when you realise that it is necessary to continue researching to discover a solution”.
Research is a race against the clock and a path that is littered with obstacles “although this should not give grounds for negativity as our progress over recent years gives us a glimpse of a near future in which the causes of vision loss and blindness do not condemn patients to darkness”. At present, Dr Monés – who has been an investigator in most of the international clinical trials on AMD conducted over the past 25 years and in many other pioneering pieces of research – is participating in several promising projects.
The visits are followed by a video conference with the biotechnology company CellCure, based in Israel, for which Dr Monés is a scientific advisor. This organisation develops stem cell therapies for retinal and neurodegenerative diseases. “Cell therapy is positioned as a therapeutic reality throughout the world. For atrophic AMD, a highly prevalent disease that currently lacks a cure, the replacement of a dead retina by a new one is still in the pre-clinical phase, but we are working on it intensively".
The research work is carried out by the Barcelona Macula Foundation (BMF), a non-profit entity that is engaged in finding a cure for degenerative vision diseases and that functions through the selfless contributions of patients, companies and institutions.
After a lunch break, there is a meeting with the research team to prepare the annual meeting of the Consortium of the EYE-RISK Project that aims to share the progress made in recent studies to identify the genetic and non-genetic determinants of AMD. “We are convinced that progress cannot be made without research and that to do so we need to observe what is going on in the world. It is also essential to form partnerships and find good travelling companions”.
When the meeting is over, it is necessary to prepare the lecture he will give at ARVO, the most important international meeting in the speciality. Dr Jordi Monés, who is a good artist, includes one of his drawings in his presentation to illustrate his new hypothesis about the progression to geographic atrophy. “Sometimes it doesn’t seem necessary to use technology to explain something. Instead, it can be depicted in a personalised way”.
The day ends with a review of important matters rather than urgent ones. “It is vital to allow space for what takes us closer to our aims, although this might not be for tomorrow. The immediate things have already been noted in the agenda”.