After receiving the national Arruga Prize, Dr Juan Cano was interviewed by the journalist Núria Mahamud. They talked about his father’s taxi, about why he opened his practice in Sant Martí, and about everything an ophthalmologist sees in an eye besides the eye.
One sentence from that interview sums up how Dr Juan Cano understands his work: “the eyes can reveal many diseases of the body, such as diabetes or arthritis”. We have gathered here what he said, because almost all of it still holds and it explains rather well what goes on in this practice.
From medical school to Hospital La Fe
He wanted to be a doctor from childhood. Ophthalmology came later, while he was studying medicine, and to specialise in it he had to leave Barcelona: he placed 290th in the national MIR examination and that year there were only a hundred posts in the city. He went to Hospital La Fe in Valencia, where he met his wife and where he wrote his doctoral thesis alongside his residency.
That thesis investigated new drugs against proliferative vitreoretinopathy, the cause of retinal detachments that come back again and again. It was awarded the prize for the best doctoral thesis in the entire Department of Surgery — not only in ophthalmology — and, five years later, another for the best thesis of the five-year period.
His father’s taxi
He paid for part of his degree working weekends with his father’s taxi. Asked what a taxi driver and a doctor have in common, his answer sets the tone of the house:
“Doctors are like taxi drivers: we spend the whole day talking and listening.”
A taxi, he said, is like a confessional: people tell you things they would not tell a friend, because they know they will never see you again. And with a patient you know, something similar happens — they are able to explain to you what is wrong.
Why Sant Martí and not the city centre
When he came back to Barcelona he chose Sant Martí for his practice. The reason he gave was simple: a densely populated neighbourhood with, at the time, little healthcare provision. And he added something that has more to do with the craft than with the market: here people know him, and that builds trust. That is how the Institute of Advanced Ocular Surgery — ICOA — was born.
The Arruga Prize
The national Arruga Prize is awarded to ophthalmologists under 40 and is hard to come by. In the interview he explained that he is the only practising ophthalmologist who holds it: despite being named after a Catalan ophthalmologist, no Catalan had won it for years.
What an eye shows besides the eye
This is the most interesting part of the interview and the part most people are unaware of. He described a patient whose diabetes he diagnosed during a routine eye examination: the man had not had blood tests for years and already had retinal haemorrhages — that is, advanced ocular diabetes.
And it is not the only one. Ocular inflammation can be the first sign of rheumatoid arthritis, lupus or ankylosing spondylitis: systemic diseases whose first manifestation appears inside the eye.
The reason why is elegant: the same blood capillaries found in the eye are in the kidney or the liver, but there they cannot be examined quickly and without cutting. The eye is the only part of the body where a living blood vessel can be seen without opening anything. A good deal of his research has gone precisely that way: the relationship between systemic disease and intraocular inflammation.
How often you should see an ophthalmologist
His recommendation was clear: once a year, and above all from the age of 35 or 40 onwards, which is when problems such as glaucoma begin to appear.
He insisted on a distinction worth keeping in mind: eye diseases are diagnosed by the ophthalmologist, not by the optician. At the optician’s they measure your dioptres, which is not the same thing. People go to the optician’s because it is convenient and the visit is not charged for — only the glasses are.
With children he was even more insistent. An uncorrected refractive error — hyperopia, myopia, astigmatism — can cause a visual delay, and a lazy eye, if it is not treated before the age of seven, is irreversible. Hence his recommendation of an annual examination up to the age of 18.
Sunglasses are not a whim
He was asked about the figure that fewer than half of the population wear sunglasses. Young people, he said, wear them as a fashion item, and older people sometimes do not buy prescription ones because they see them as “yet another expense”.
The medical argument carries weight: looking at the sun unprotected can cause solar retinopathy, which leads to irreversible loss of vision, and it brings forward the appearance of cataracts. And they are worth buying at an optician’s, because bad sunglasses do more harm than none at all.
Almost twenty years later
The interview is some years old by now: today Dr Cano devotes most of his surgical activity to cataract and refractive surgery, and the clinic is at C/ Bolívia 160. But the advice he gave then has not changed one comma: one examination a year, and children before the age of seven.
Interview conducted by the journalist Núria Mahamud and published in the local press of Barcelona after the award of the national Arruga Prize. This text is a summary prepared by Policlínica ICOA; the rights to the original article belong to its author and to the publication that printed it.
We are at 160 Carrer de Bolívia, Monday to Friday.