2023-06-30 15:58:13
Eye pointing is the last movement that allows people with amyotrophic lateral sclerosis (ALS), in the more advanced stages of the disease, to communicate. Cataract surgery – about 87% of eye surgery – which allows these patients to maintain a relationship with the outside world and a better quality of life, however has clinical complexities. Precisely for this reason, cataract surgery successfully completed on a person who has been living with the disease since 2009 is of particular importance. In recent days, the alliance of three teams has restored to Attilio Fornoni, as the patient is called, the clear vision compromised by the opacification of the lens: the multidisciplinary team expert in neuromuscular pathologies of the Nemo Clinical Centers, the one of advanced technological innovation of Nemo Lab and the specialist one of the Holy Family Foundation of Cesano Boscone (Milan). The news comes in the month dedicated to ALS Global Day, recalls a note from the Italian Amyotrophic Lateral Sclerosis Association (AISLA).
“For a complex pathology such as ALS, which has a major impact on a person’s life and on his system of relationships – says Alberto Fontana, president of the Nemo Clinical Centers – the process of taking charge must prioritize attention to those details of everyday life that guarantee its dignity. This is why preserving visual health means first of all responding to the primary desire to continue building social relationships, allowing for the best use of alternative augmentative communication systems”.
Visual management – underlines Aisla – should be an integral part of multidisciplinary management for complex pathologies such as ALS. The optometric service coordinated by Federica Cozza has been active at the Nemo Clinical Center in Milan since 2016 and today, thanks to the collaboration with Danilo Mazzacane, an ophthalmologist, the research and treatment laboratory of Nemo Lab is also involved, the hub born in 2021 in in the wake of the experience on neuromuscular pathologies of the Nemo network. In recent years, 958 evaluations have been carried out by the service, of which over 750 for people with ALS. The management of visual function takes place from diagnosis throughout the course of the disease.
“Mr. Fornoni’s visual monitoring – reports Mazzacane – as happens with all patients, made it possible to evaluate with him how the glasses no longer gave any benefit. In fact, the poor visual acuity required the need to greatly enlarge the characters on the screen of his communicator “, making social interactions even more difficult. Cataract surgery will allow him to have clearer vision, thus regaining effective use of the communicator. We are happy because the success of the surgery will actually improve his quality of life”. For Mariapia Garavaglia, president of the Ambrosiana nursing home of the Holy Family Foundation, “the successful model of intervention signals the peculiarity of specialist assistance and specific competence in the treatment of people with different degrees of disability. The excellence of other hospitals in the city, but it is a fact that our structure knows how to welcome and adequately treat people who have some frailty”.
It is “an important result – comments Fulvia Massimelli, national president of Aisla – which underlines once again how decisive the process of sharing scientific, clinical and specialist skills is. ALS mortifies our body, making it immobile. An extreme condition that imposes the need to preserve our eyes, the only tool that allows us to continue to communicate.Where it is not yet possible to heal, therefore, Mr. Fornoni’s story tells us how essential it is to know how to take care, to protect and guarantee our quality of life”.
The exceptional nature of the intervention carried out by Felicita Norcia, of the ophthalmic surgery team of the Ambrosiana nursing home, coordinated by Mario Giò, is precisely given – remarked Aisla – by the complexity of the clinical needs of a person with ALS, which required a assisted process of a multiprofessional team from the three centres: optometrist, ophthalmologist, neurologist, pulmonologist and anesthetist worked in synergy to monitor the entire process. At their side are Attilio’s wife, Mrs. Elvira, and their son Eliano, an expert caregiver, who also accompanied his father during the operation to transfer all his needs to the clinical team.
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