Categories
Music

Visual Health and Performing Arts

As the UK’s only BAPAM registered performing arts specialist optician, we are often asked what’s so special about musicians’ eyes? The simple answer is nothing, they are no different to that of a pilot, plumber or podiatrist. However, the way performance artists use their eyes is. Performance artists have specific eye care needs: for example, they might need to read detailed musical scores quickly, switch focus between near and far objects, such as a music stand and the conductor, and most need to have a good sense of spatial awareness.

During initial consultations, many performance artists tell us of their frustrations with poor visual acuity, reduced field of view, poor contrast and a general dissatisfaction with the quality of vision correction that their glasses or contact lenses provide. This is because the performance arts industry is so poorly served by mainstream optics. We want to change that.

Does your poor vision or eye health affect your ability to perform as a musician? If so we’d like to invite you to come and join us at the Department of Music at the University of York on Thursday 7th July 2022. In conjunction with BAPAM, Dr Naomi Norton and the team at York University, Allegro Optical will be taking part in a free networking event geared towards performers, clinicians, device manufacturers, and organisations. 

A primary goal of the event is to raise awareness of the unique visual challenges that musicians and other performing arts professionals face. Performing artists have specific vision requirements: for example, they may need to read detailed musical scores quickly, switch between near and far distances, and have a good sense of spatial awareness.

The collaboration will facilitate network development, identify topics for research and education, review risks to performing artists and identify care pathways, and enhance clinical practice effectiveness.

There will be a variety of presentations, panel discussions, and networking opportunities. The event will begin at 9:30 and end at 16:30. University of York Place and Community Fund has provided funding for this event, so attendance is free and refreshments and lunch will be provided.

Those interested in registering for this event should complete the registration form and contact Naomi Norton at naomi.norton@york.ac.uk with any questions. Due to the limited number of tickets available for this event, we have capped the number of tickets available for each ‘category’ of delegate. Each type of ticket is issued first-come, first-served, but there will be a waiting list. If you are unable to attend due to an unexpected change in plans, please contact us as soon as possible at naomi.norton@york.ac.uk.  

If you are unable to attend the event in person on Thursday 7th July 2022 but are interested in visual health in performing arts and would like to be updated about the event, future plans, and other opportunities related to this topic, please answer only the final question before clicking ‘Submit. Your contact information will be used only as stated and will not be shared with any third parties. 

To find out more & to register visit: https://buff.ly/38ZJ9Lb

Categories
Music

#SeeTheMusic and More – Blepharitis and the performing artist

Blepharitis and the performing arts professional

As the UK’s only performing arts eye care specialist practice and the only optician registered with BAPAM, we understand the negative impact eye conditions can have on careers. 

We have assisted performing arts professionals such as musicians, dancers, singers, presenters, and technicians, such as sound engineers and AV technicians, in seeing the music.

We will all experience vision problems at some point in our lives. In most cases, these problems are caused by refractive errors, which affect how the eyes focus light rather than being caused by an eye disease or disorder. However, many of us can be affected by eye diseases or disorders. Performing arts professionals experience various eye conditions that we examine in this blog series. 

Blepharitis

In the medical world, blepharitis (blef-uh-RYE-tis) refers to irritated, swollen eyelids. It is the most common eye disorder. Despite being a chronic (ongoing) condition, it can often be managed by patients themselves with the advice of an eye care professional.

Blepharitis typically affects both eyes along the edges of the eyelids. Tiny oil glands at the base of the eyelashes become inflamed. Redness and inflammation are caused by clogged pores. Blepharitis can be caused by several diseases and conditions.

Symptoms of blepharitis include;

  • Having itchy eyes
  • The eyes feel gritty
  • Eyelashes that are flaky or crusty
  • Eyelids sticking together on waking in the morning
  • Feeling of burning in the eyes
  • Light sensitivity
  • Blurred vision
  • Dry eyes
  • Red eyes
  • Watery eyes

Causes of Blepharitis

Blepharitis is usually caused by an excess of bacteria on your eyelids near the base of your eyelashes. Bacteria on your skin is normal, but too much bacteria can be harmful. Blepharitis can also occur if the oil glands in your eyelids get clogged or irritated. 

The exact cause of blepharitis isn’t clear. It might be associated with one or more of the following:

  • The precise cause of blepharitis is unknown. It could be related to one or more of the following:
  • Seborrheic dermatitis is characterised by scalp and brow dandruff.
  • clogged or dysfunctional oil glands in your eyelids
  • Rosacea is a skin ailment that causes facial redness.
  • Allergies, such as responses to eye medicines, contact lens solutions, or eye makeup
  • Lice or eyelash mites
  • Eyes that are dry

Complications

If you have blepharitis, you might also have:

  • Eyelash issues. Blepharitis can cause your eyelashes to shed and grow unnaturally (misdirected eyelashes), or lose colour.
  • Skin concerns on the eyelids Long-term blepharitis can cause scarring on the eyelids. Or the eyelid margins may turn inward or outward.
  • Excessive weeping or dryness of the eyes. Abnormal oily secretions and other debris shed from the eyelids, such as dandruff flaking, can accumulate in your tear film — the water, oil, and mucus mix that creates tears.
  • An abnormal tear film makes it difficult to keep your eyes moist. This can irritate your eyes and produce dryness or excessive tears.
  • Stye. Styes are infections that form near the base of the eyelashes. As a result, you’ll have an uncomfortable bump on the edge of your eyelid. A stye is most commonly seen on the surface of the eyelid.
  • Chalazion. A chalazion happens when one of the tiny oil glands at the edge of the eyelid, right behind the eyelashes, becomes clogged. This obstruction promotes inflammation of the gland, causing the eyelids to enlarge and redden. This may clear up or become a firm, non-tender lump.
  • Pink eye that is persistent. Pink eye can be brought on by blepharitis (conjunctivitis).
  • Corneal abrasion. A sore on your cornea can develop as a result of constant irritation from irritated eyelids or misdirected eyelashes. A corneal infection might be exacerbated by a lack of tears.

Performing Arts Professionals and Blepharitis

Many performing artists are at particular risk of developing Blepharitis due to its close links with dry eye disease. Many eye specialists and dermatologists believe that there is a link between dry eye disease and blepharitis. As we age, we experience changes or reductions in our normal meibomian gland secretions. This decline in secretions can be an indication of gland dysfunction. Changes in our Meibomian glands play a significant role in the increase of symptoms of dry eye especially in dry environments such as on stage, in the rehearsal room and in the orchestra pit.

How do I know if I have Blepharitis?

  • Examining your eyes. Your Optometrist might use a special magnifying instrument to examine your eyelids and your eyes.
  • Skin Swabbing for testing. In certain cases, your GP might use a swab to collect samples of the oil or the crust that forms on your eyelid. This sample can be analysed for bacteria, fungus or evidence of an allergy.

Blepharitis Treatment

There is no cure for blepharitis but the condition can be managed by looking after your eyelids. Using a warm compress over closed eyelids can often soften the crust and loosen the debris. Keeping the eyelids clean often helps to ease the symptoms. 

Depending on the cause of the condition, the Optometrist may suggest the use of artificial tears or a lubricant to help restore your eye health. Antibiotics, antiviral drugs, and other medications may also be prescribed as part of a treatment plan. The insertion of punctal plugs can help to block the tear ducts, allowing more tears to stay in the eyes.

These plugs are small devices that are placed in the tear ducts. This helps keep the tears on the eyes surface improving comfort and relieving itchy, burning and red eyes.

Left untreated Blepharitis can lead to dry eyes, baldness in the eyelashes, and excessive tears. A healthy lifestyle can help prevent the condition. It is especially important to clean your eyes and remove all makeup before bed. Do this regularly to maintain your eye health

In Summary

As the UK’s only specialist Performing Arts eye care provider we understand more than most just how much dry eye conditions can impact a performer’s career and everyday life. 

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians using cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve performing arts practitioners’ vision problems. To help in the treatment of Blepharitis we have developed a Unique Blepharitis Treatment Programme. This is a management program consisting of:

  • Initial 30 minute consultation with a dry eye specialist Optometrist, followed by reviews within the first 3 month period as necessary
  • Up to 3 appointments with an Optometrist and/or Dispensing Optician throughout the year
  • Preferential discounts of products to manage your condition
  • All this for just £4.99 per month
  • Treatment may consist of:
  • Ocular lubricants
  • Heat treatment
  • Lid massage
  • Lid hygiene
  • Supplements

If you are suffering from any of the conditions mentioned above or have any of the symptoms described then please speak to one of our staff.  To book an appointment or find out more about our exclusive dry eye programme, Call us today and speak to a member of our team. 

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/

Categories
About Allegro Music

Now Yanna can see the music

A talented pianist’s search for help to see the music

In this blog, we look at how a talented and inspiring Pianist was helped by our specialist musicians’ glasses. Yanna is a fascinating woman, and it has been a pleasure to collaborate with her. Her music history encompasses the traditions of her family’s heritage, (Asia Minor) and the complexity of her musical background, as evidenced by a successful career as a teacher, concert pianist, conductor, and accompanist.

Yanna was born in Thessaloniki, Greece and is a proud citizen of both Greece and the UK. She grew up with a wide range of musical influences from her parents’ unusual musical interests that covered everything from Greek folk music and Theodorakis to Tchaikovsky and Bartok.

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From a young age, Yanna played the piano for her parents and their friends, reading from a piece of faded photocopied ‘fake’ sheet music with all the fashionable tangos, waltzes and ballads of the 1930s and 40s as they all sang in harmony.

Yanna is an experienced pianist and accompanist. In 1987 she was awarded the Dimitri Sgouros ‘Prize and Scholarship’ by the New Conservatory of Thessaloniki from where she graduated in 1988 with the ‘Diploma for Piano performance and teaching’. 

London Calling

She continued her piano and conducting studies at the Royal Academy of Music in London, where she was awarded the Cipriani Potter Exhibition prize during her second year as an ‘Advanced Studies’ student. She graduated with the ‘Diploma of Advanced Studies’ in 1990. Yanna moved to the US in 1991 where she gained her Master’s degree in ‘Piano Performance and Literature’ at the Eastman School of Music, Rochester NY U.S.A. in 1993.

After a 10-year worldwide concert career, Yanna settled in the UK where she raised a family, taught the piano privately and classroom music since 1993. Since 2018, Yanna is getting back to performing professionally and is currently preparing her first solo CD album which is due to be released in December 2022.

In 2018 Yanna co-founded ANIMO, a flute and piano duo, with her friend Sarah Waycott. Since 2019, she is the proud owner of a Gustav Klimt (Goldene Adele) Bosendorfer 214 VC which she has used for several recordings, Animo’s first and second CD albums and weekly Livestreams during the last few years.
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Yanna needed to see the music

Having always had a relatively high myopic prescription Yanna is an experienced spectacle wearer. However, the varied focusing distance required of a professional pianist was beginning to present her with the problems associated with presbyopia which are very familiar to us at Allegro Optical. Yanna needed to see her music on the stand, her musical collaborators and ideally a good view in her periphery.

Yanna first contacted Allegro Optical in February 2020, just before the COVI|D-19 crisis and the ensuing national lockdown.

She explained that she played a grand piano and had begun to struggle with blurry notes and indistinguishable shapes and lines. Yanna told us that when playing professionally and performing downlighters or overhead lighting reflected and displaced the image she saw. This caused all the notes to become blurry. The reading glasses that were made for her were impractical and her varifocal lenses gave too narrow a field of view.

Yanna booked her first appointment with Allegro Optical for Friday 27th March in Greenfield, Saddleworth. That was unfortunately postponed due to the first 2020 lockdown and Yanna didn’t get to visit us until September the same year. In the meantime, Yanna began having some issues with a retinal tear and was referred to Birmingham Midland Eye Center for further advice and investigation.

Following her discharge from the hospital in August 2020, Yanna contacted us again and we arranged an appointment in September of the same year.

A bit of a conundrum

The day of Yanna’s visit was an extremely busy day, with a very full clinic. Optometrist and flautist Amy carried out a thorough eye examination and noted Yanna’s complex ocular history and her many working distances. She then produced a prescription

covering all Yanna’s working distances and then introducing her to dispensing optician Sheryl.

Sheryl took all of Yanna’s facial measurements to help her find a frame that fitted perfectly, both in terms of comfort and performance. Well-fitted frames would provide the perfect mount for Yanna’s complex lenses. The frame also had to be practical but reflect Yanna’s unique style and work with her deep colouring. They also had to stay put while Yanna was playing. Little did the pair realise this meeting was to be the start of a long-time collaboration and Yanna now works with Allegro Optical to help us develop musicians’ eye care further and to raise awareness among performing artists of the need for specialist eye care.

Multiple distances require multiple solutions

After some discussion, Sheryl was concerned that including her correction for an elevated music stand in one pair, would compromise Yanna’s field of view and posture. To give the very best solution they settled on one pair of varifocals for everyday wear and another for use with a music stand.

Yanna opted for a Hook LDN HKS011 frame in Navy and Tortoise as the colours complimented her colouring, reflecting her personality while providing a comfortable fit and good lens size. We glazed these lenses with an individualised freeform varifocal in 1.74 index lenses with Transitions® Signature® GEN 8™, the first intelligent photochromic lens with their breakthrough nanocomposite technology that enhances photochromic performance and provides optimal vision, comfort and all-day protection.

Something for the piano

To provide the widest possible area for music (about 1.2 meters across and elevated) Sheryl dispensed a pair of spectacles with our Fogoto lenses to provide the widest and deepest field possible.

This time Yanna opted for a traditional yet iconic style of frame, choosing the Anglo American 313, HYBG. Again we decided to glaze these lenses with Transitions® Signature® GEN 8™. Yanna’s music room has a lot of glass with two huge windows. Glare is often a problem and a photochromic lens option appealed to her.

Things don’t always go to plan

When Yanna collected her new spectacles she was delighted with the varifocals, but it quickly became apparent that there was an issue with the right eye in the music spectacles. While the vision in her left eye was in her words “amazing” the music in the right side of her right eye appears blurred. We invited Yanna back for further investigation. Optometrist and Gospel Singer Gemma carried out a detailed eye exam and found that Yanna had some partial defects on her binocular visual field exam, possibly caused by some slight scarring. Yanna had developed a “Weiss ring”, a circular peripapillary attachment that forms following a Posterior Vitreous Detachment (PVD) from the optic nerve head. We then worked some prism into Yanna’s lens design to try to resolve the issue by moving the image she sees from the scarred area of the retina.

Yanna visited Birmingham Midland Eye Centre again in March 2021 but decided against vitrectomy surgery because of the risk of retinal detachment. In January 2022 Yanna felt she needed a change of glasses and she again travelled up to Meltham. This time she saw Optometrist and fellow pianist Liz. Liz conducted a 3D OCT examination which revealed a large mass of floaters from Yanna’s previous PVD in the right eye and a partial PVD in the left eye.

Time lapse

Since her last visit, we had invested in a Saccadic Clinical Eye Tracker allowing Liz to assess binocular function while the patient is sight-reading or making a series of saccades or performing other complex tasks. This was a game-changer for Yanna as the examination revealed her binocular vision to be a little unstable. Her fixation disparity varied and prisms now preferred the opposite to phorias. Liz also found that while the right eye was dominant in the distance Yanna was now left eye dominant near. The floaters in her right eye also seemed to be causing problems.

The trick now was to create a pair of spectacles that would help Yanna to continue playing despite all her vision problems. Sheryl designed a pair of lenses that would make the most of Yanna’s limited vision in her right eye. With a difference of nearly three diopters, there was a danger of double vision caused by differing image sizes. This was resolved by using different indices and asphericising the right lens to reduce minification. Using computer numeric control technology we were able to create a lens that minimised optical aberrations giving Yanna the best vision possible.

When Yanna collected her glasses we ran the same Saccadic Clinical Eye Tracker exam with her new glasses on. The exam revealed no binocular problems whatsoever. Yanna was delighted and it wasn’t long before she left the following Google review.

Yanna said; “Probably the most thorough, knowledgeable and persistent in getting results opticians I have ever encountered! I went to Allegro Optical initially for musician’s glasses. I really wanted to be able to see more when performing on stage and to be able to communicate with my duo colleagues rather than looking at a foggy outline or having to swap glasses all the time.  Unfortunately, a retinal tear that developed immediately after I made my first appointment in 2020 and COVID getting in the way of everything, we had to work around many difficulties, none of which deterred the owner Sheryl Doe, who was determined to make me the best possible pair of glasses as close to the original brief as possible. And in April 2022 they did! I am the very happy owner of two fantastic pairs of specs, one varifocal and the other my “magic” pair for playing the piano and working on the computer. This was all possible thanks also to their new saccadic eye scanner which showed them exactly the kind of issues I had to struggle through when I was reading a score. The result is miraculous! I can see better, my eyes are more relaxed, I am not getting a single headache from reading music or working on the computer and as for my varifocals, it’s like I am not wearing glasses, that’s how comfortable they are! Allegro, Optical thank you!

I would recommend Allegro’s unique skills to anyone, particularly if you are struggling with any eye issues or you want to be able to read music effortlessly. Superb service in every way!”

Why do musicians come to Allegro Optical?

As an independent family run business, we are gaining an international reputation for professional excellence and an inventive approach to meeting customer needs.

Now known internationally as the ‘Musicians Opticians’ we are attracting many clients from across Europe and further afield. Our groundbreaking work with performers, players and conductors has resulted in Allegro Optical becoming the first and only opticians to gain registration with the British Association for Performing Arts Medicine (BAPAM).

We treat each client as an individual and it is true that no two musicians are the same, So why should their vision correction be? We enjoy creating unique lenses to meet a musician’s particular needs. As musicians ourselves we can ask the right questions and interpret the answers accordingly.

Award-winning eye-care

So successful has Allegro Optical been in helping performers that this year alone we have scooped no less than five national and regional awards. These awards include the National ‘Best New Arts & Entertainment Business of the Year‘ at a gala event in London. Managing Director Sheryl Doe was awarded the 2019 ‘Dispensing Optician of the Year‘ and in 2021 Allegro Optical Dispensing Optician Kim Walker scooped the same title.

The company has been featured in many national publications including The Times 4BarsRest, The British Bandsman and Music Teacher Magazine.
Are you a musician who is struggling with their vision? Is making music no longer the enjoyable experience it once was? If so call us at Greenfield on 01457 353100, Marsden 01484 768888 or Meltham on 01484 907090.

Categories
About Allegro Music

It’s ME Awareness week

M.E. (Myalgic Encephalomyelitis) is a term that is frequently used interchangeably or in conjunction with the term Chronic Fatigue Syndrome (CFS). It is a condition characterised by a variety of symptoms such as chronic fatigue, restless sleep, muscle discomfort, cognitive dysfunction (‘brain fog’, sensitivity to sound and light, melancholy, anxiety, irritability, and mood swings. Other symptoms of ME/CFS include food allergies or sensitivities, digestion issues, chills and night sweats, disorientation, and fainting.

But why is an optician talking about ME we hear you ask! 

Many people are unaware that ME/CFS can cause a broad spectrum of vision-related symptoms. Eye pain, photophobia (light sensitivity), visual processing issues, floaters and spots, tearing, dry eyes, poor focus, double vision, scotomata, blurred vision, tunnel vision, night blindness, depth-of-field loss, nystagmus, and early cataracts are just some of the symptoms.

In a 2001 Belgian study of 2073 CFS patients, 74.4% of patients satisfying the Fukuda criteria and 77.2% of patients meeting the Holmes criteria had visual acuity issues. About three-quarters of ME / CFS patients report eye and vision problems.  Additionally, some ME patients demonstrated reduced binocular eye movement control during non-reading tasks, when compared to controls.

An example of a commonly reported vision problem is reading difficulties and vision-related symptoms (e.g., pattern glare, headaches, difficulty tracking lines of text) when reading, especially when reading for long periods of time. Studies have found that despite the fact that ME/CFS is not associated with poor reading acuity or visual acuity for letters or cognitive deficits, increased susceptibility to visual crowding may contribute to challenges with reading. All Allegro Optical practices are equipped with visual stress analysis equipment and all offer overlay assessments and colorimetry.

Saccadic eye movements and ME

Patients with ME may have impaired eye movements when reading or performing non-reading tasks. It may be possible to shed some light on the causes of reading-related visual discomfort among ME patients by studying eye movements while reading.  With our saccadic eye tracker, we can systematically examine eye movement during reading and non-reading tasks. 

As the only optician in the Huddersfield and Holmfirth area to invest in saccadic eye-tracking technology Allegro Optical is better equipped than most to assist with these problems.

            ME and regular eye exams

Our eyes work constantly throughout the day. That’s why we believe in preventative care – getting regular check-ups. By doing so you can enjoy early detection of problems and avoid what could potentially become more significant issues in the future. 

If you suffer from ME and you are experiencing any eye or vision-related symptoms, book an eye exam as soon as possible. It’s recommended that most people should get their eyes tested every 2 years. However, it’s best to attend earlier if any eye problems occur or if advised by your GP.

If you would like to book your eye examination call Allegro Optical in either Marsden 01484 768888, Greenfield 01457 353100 or Meltham 01484 907090 to find the perfect match. Also, follow us on Twitter @AllegroOptical. Or on Instagram @allegrooptical.

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About Allegro Music

#SeeTheMusic and More – Glaucoma, the silent thief of sight

Eye conditions and the performing arts professional

Being the only performing arts eye care specialist in the UK as well as the only optician registered with BAPAM , we fully understand how issues with the eyes can negatively affect a performer’s career.

Musicians, dancers, singers, presenters, camera operators, sound engineers, and video technicians have all benefited from our assistance.

We all may experience vision problems at some point in our lives. Most of these problems are caused by refractive errors, which affect the way the eyes focus light, rather than an underlying condition or illness. Nevertheless, eye conditions affect many people. The purpose of this blog series is to examine common eye disorders experienced by performing arts professionals.

Glaucoma – What exactly is it?

The term “glaucoma” refers to a group of diseases that affect the optic nerve, which connects the retina to the brain, resulting in a loss of peripheral vision. Primary open-angle glaucoma (POAG) is the most common form of glaucoma.

Of the multiple types of glaucoma, the two main types are open-angle and angle-closure glaucoma.

Variants of open-angle and angle-closure glaucoma include:

  • Secondary Glaucoma.
  • Pigmentary Glaucoma.
  • Pseudoexfoliative Glaucoma.
  • Traumatic Glaucoma.
  • Neovascular Glaucoma.
  • IridoCorneal Endothelial Syndrome (ICE)
  • Uveitic Glaucoma.

As glaucoma is asymptomatic, but causes irreversible vision loss, it has been referred to as the “silent thief of sight.”. According to the World Health Organisation, it’s a leading cause of irreversible blindness (World Health Organisation, 2010). (Bunce et al., 2010) cites it as the second most common cause of visual impairment registration in England and Wales. Glaucoma is an umbrella term for a large group of disorders with a wide variety of clinical and pathological characteristics. The common characteristics are: 

  • Optic nerve damage
  • Visual field loss

The disease is a silent progressive disease and, if detected and treated early, is preventable and can lead to significant visual impairment or blindness. Diagnosis is crucial, and adherence to treatment is essential to prevent vision loss.

Glaucoma accounts for the majority of the workload (1 million visits per year) in  UK eye clinics. About 2% of people over 40  years of age and nearly 10% of people over  75 have primary (chronic) open-angle glaucoma (POAG). Only about half are diagnosed (National Institute for Health and Care Excellence, 2009). The social and economic burden of glaucoma-related vision loss and  workload is likely to increase due to longer life expectancy (Coleman and Miglior, 2008; Burr et al., 2007). Because glaucoma patients may  have no symptoms until they have lost their vision, then the loss of vision is irreversible. Once vision loss is apparent, 90% of the fibres of the optic nerve  may be irreparably damaged (NICE, 2009). Treatment slows progression by lowering intraocular pressure (IOP).

Consequences of glaucoma for the performer

Damage to nerve cells in the retina leads to damage to the visual field. Peripheral fields are usually damaged first. Loss of peripheral vision may go unnoticed until it reaches a significant level, due to the small role that peripheral vision plays in the overlapping vision of our eyes and in perceiving what most people can see. Deterioration usually progresses slowly over the years, although some types of secondary open-angle glaucoma can progress faster.

Performers, particularly musicians who play larger instruments such as pianos, organs and large percussion use their peripheral vision more than most. As a result the symptoms of peripheral vision loss may well be detected sooner. 

Some instrumentalists however may be at an increased risk of the condition. Recent studies suggest that musicians playing high-impedance wind instruments may be susceptible to glaucoma. This could be because the Valsalva manoeuvre is generated when blowing into a high impedance wind instrument. The Valsalva manoeuvre has been reported to cause high intraocular pressure (IOP). 

High and low resistance wind musicians experience a temporary increase in intraocular pressure while playing their instrument. The magnitude of the IOP increase is greater for high resistance players than for low resistance players. High-resistance wind musicians have a lower incidence of visual field loss than other musicians but IOPS are significantly higher, which is associated with lifetime playing time. The cumulative effects of long-term intermittent elevated IOP while playing high-resistance wind instruments could cause cell damage and possibly lead to an increased risk of developing glaucoma.

How do we check to see if you are at risk of glaucoma?

Tonometry

Our optometrists perform a number of different tests to look for glaucoma. We use a device called a tonometer to measure the pressure inside your eye. Our optometrist will put a small amount of anaesthetic and dye into the front of your eye. They will then shine a light into your eye and then use a tonometer to measure the pressure in your eye. Some optometrists use a different instrument that uses a puff of air called a non contact tonometer which does not touch the eye to check the pressure.

A visual field test determines whether any portions of vision are missing. It’s possible that you’ll be shown a series of light dots and asked to press a button to indicate which ones you saw. Some little dots may appear at the periphery of your vision (peripheral vision), which is generally the first area of glaucoma to be impacted. If you can’t see the spots you may be at risk of glaucoma.

Evaluation of the optic nerve 

Because the optic nerve, which connects your eye to your brain, can be damaged in glaucoma, an examination may be performed to determine its health.

Slit Lamp Exam

Eye Drops will be used to dilate your pupils for the test. Your eyes are then examined using a slit lamp (a microscope with a bright light) Slit-lamp examination of the optic nerve magnifies the view with hand-held lenses, allowing for greater control over the examination. This technique produces a stereoscopic, inverted image of the optic nerve.

Optical coherence tomography (OCT) tests create a topographical map of the optic nerve by taking cross-section pictures of the retina with non-invasive light waves. The thickness of the nerve fibre layer, which is the portion of the optic nerve most vulnerable to eye pressure elevation, is measured by an OCT test.

Referral to a specialist

If signs of glaucoma are detected during any of the tests, you will be referred to an ophthalmologist for further investigation. If you do have glaucoma the ophthalmologist will confirm your diagnosis and find out:

  • how far the condition has progressed
  • how much damage has been done to your eyes
  • what may have caused the condition

The ophthalmologist will be able to advise on treatment. 

In some cases, your ophthalmologist will continue to treat you. But for less serious types of glaucoma, you may be referred back to the opticians.

Treatment

There are a few courses of action to treat glaucoma, including eye drops, laser treatment and surgery. The best treatment for you will depend upon your condition.

Eye Drops

Treatment can’t reverse any vision loss but it starts with eye drops. These can help reduce IOP by improving drainage from your eye or by reducing how much fluid your eye makes. Depending  how low your eye pressure should be, more than one type of the eyedrops may be recommended.

Laser Treatment

Laser treatment might be suggested in the event that eye drops don’t work.

This is where a high-energy light is focused on part of your eye to stop or reduce fluid build up.

Sorts of laser treatment include:

laser trabeculoplasty

a laser is used to open up the vessels inside the eye,  to allow more fluid  to empty out and reduce the tension inside

cyclodiode laser treatment

a laser is utilised to remove a small amount of eye tissue that delivers the fluid, which can then decrease pressure in the eye

laser iridotomy

a laser is used to make openings in the iris to permit liquid to escape from your eye.

Surgery

In situations where eyedrops or laser treatments haven’t been successful surgery may be offered.

The most well-known sort of a medical procedure for glaucoma is called trabeculectomy. It includes removing part of the eye’s drainage mechanisms to permit more liquid to escape without any problem.

There are other glaucoma surgical options, including:

trabeculotomy — similar to a trabeculectomy, other than a tiny segment of the eye-drainage vessels are removed using an electric current.

A segment of the white outer covering of the eyeball (the sclera) is removed to allow fluid to drain more easily from the eye.

Deep sclerectomy — the drainage channels in the eye are enlarged, sometimes with the insertion of a small device.

trabecular stent bypass – a small catheter is inserted into your eye to improve fluid outflow.

Conclusion

Patients with chronic conditions, such as glaucoma, should work with their optometrist and other eye care professionals. Preventing irreversible and severe vision loss necessitates early detection and screening.

Getting regular eye exams is now the easiest approach to avoid major glaucoma damage.

Most people can keep their vision with early identification and meticulous, lifetime treatment. In general, a glaucoma check should be performed:

  • under age 40, every two years
  • from age 40 to age 64, every 12 months
  • after age 65, every six to 12 months

A screening should be done every year or two in those with high risk factors after 35. In addition to people of African descent and people with diabetes, those with a family history of glaucoma and wind instrumentalists have an elevated risk of getting glaucoma. If you have a parent or sibling with glaucoma, you are at higher risk.

Benefits of Exercise

A moderate exercise program is beneficial to your overall health, and studies have shown that moderate exercise, such as jogging or walking, three or more times a week, can lower IOP.

You can only reap the benefits of exercise for as long as you continue to exercise; this is why moderate exercise on a regular basis is recommended. The practice of yoga can be beneficial, but it’s important to avoid inverting positions, such as headstands and shoulder stands, as these can increase IOP.

If you have any questions or concerns regarding an exercise program, you should speak with your doctor.

Keep Your Eyes Protected

While participating in sports or doing home improvement projects, it is important to wear protective eyewear.

Protecting your eyes from injury is another way to prevent glaucoma. Traumatic glaucoma and secondary glaucoma are both caused by injury to the eyes.

The best defence against glaucoma and other eye diseases is a regular comprehensive eye exam.

In Summary

The optometrists at Allegro Optical have the technology, facilities, including our fantastic 3D OCT eye scanners, and experience to determine if your eye flashers are serious. Early detection and treatment are critical for preserving your vision, eye health, and performing arts career.

As the UK’s only specialist Performing Arts eye care provider we understand more than most just how much dry eye conditions can impact a performer’s career and everyday life. 

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians using cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve performing arts practitioners’ vision problems. 

If you are suffering from any of the symptoms mentioned above or have any of the symptoms described then please speak to one of our staff.  To book an appointment or find out more about our exclusive dry eye programme, Call us today and speak to a member of our team. 

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/

Categories
Music

Guest blog by pianist Norma Wilson

Norma Wilson is a pianist and flautist from the West Country. She first visited Allegro Optical in 2020 and has since collaborated with us on several projects including The RSM & BAPAM, Sustaining A Career Into Old Age podcast. 

In this blog, Norma talks about how Wet Macular Degeneration has impacted her career and how she manages her condition to continue playing.

Wet Macular Degeneration – a musicians perspective.

I am a keen amateur musician.  From a young age I would borrow music scores from the library and I am a proficient sight-reader.  In 2016 I was diagnosed with Wet Macular Degeneration in both eyes. The onset was very sudden ( I noticed Fiona Bruce looked beetroot colour with a very long face when I watched the News) and when the second eye was affected I was devastated when the Eye Consultant said it could affect the way I read music. 

I had noticed that when I looked at music notation the lines were wavy, there were some blurry patches.  The main problem was the light, I would get a sparkling effect when I moved my eyes from the score to the keyboard and back again.  The light was refracted and I had a general feeling that my vision was distorted.  

Fortunately, I read an article about Allegro Optical, in SideView, the Macular Society Newsletter.  I live in Bristol but made the journey to Meltham to see if they could help me. Allegro Optical describe themselves as a musicians’ optician.  It was a very different eye assessment, I took music along, there was a piano and a music stand.  The measuring process to make me special ‘music reading glasses’ took quite a while.  Allegro Optical have a piano and music stands, so I took some music with me and my flute which I play as well as the piano. 

  • I had an eye test, which included an OCT scan, a field of vision scan my eye movements were tracked and I had an eScoop assessment for my AMD.
  • They measured the distance between the music score to my eyes both seated at the piano and standing with my flute in front of a music stand.  They were trying to find my ‘working distance’  in my case 21 “
  • My previous optician had tried several times to make me some music reading glasses, they were single view with increased magnification, but that did not address the problem and created more distortion and reduced the field of vision. 
  • Allegro Optical were considering colour and prism. They measured eye to music, eye to stand, eye to piano and how wide my field of vision was. I was persuaded to have a slight yellow filter, I have to say this has helped reduce the sense of eye strain. 

When we consider how a musician reads a score we know that

  • You often read more than one line at a time, treble and bass clefs, but if you play with other people you read across four or more staves.  Your eyes are looking up and down and across. If you then turn your gaze away from the score to look at your fellow musicians you are looking into a different light source and back again. 
  • Light is of the essence, so getting advice on this is important. 
  • Relying solely on reading from a paper score is not always easy so over the years I have been advised to get an IPad Pro (larger iPad A4) and to use several Apps:
  • it depends greatly on which software is used, but Scoringnotes.com for instance tends to make adaptations that work for the visual effect of the score.
    > More detailed information on this can be found here:
    https://www.imore.com/best-music-reading-apps-ipad
    https://www.musicnotes.com/now/tips/the-3-best-hands-free-page-turners/
  • IMSLP  International Music Score Library Project  it started in February 2006. It is a project for the creation of a virtual library of public domain music scores based on the wiki principal. There is  forScore, Piascore, Musescore etc

I was advised that I scan my own score and then get it in Dropbox and then get that into the App ForScore which I use on the iPad. But whether or not you do that or just download, the important thing to get it bigger is to have an iPad Pro (large screen size) and then turn it on its side. That makes the music much bigger—though of course then you have to turn the page twice as much! Using an iPad also helps because it is backlit so the light is more consistent. 

It is important for me that I continue to play music as I age and with my specialist music reading glasses, iPad and the use of various Apps I know I can continue for many years to come. 

Norma Wilson

Categories
Music

#SeeTheMusic and More -Floaters and Flashes, what are they and should you worry?

Eye conditions and the performing arts professional

Because we are the only performing arts eye care specialist in the UK and the only optician registered with BAPAM, we understand how eye conditions can negatively impact a performer’s career.

Performing arts professionals, such as musicians, dancers, singers, presenters, camera operators, sound engineers, and video technicians, have all benefited from our assistance to see the music.

We are all likely to encounter vision problems at some point in our lives. Most of these problems are caused by refractive errors, which affect the way the eyes focus light, rather than a condition or illness affecting the eye. Even so, many of us could be affected by eye conditions. In this series of blogs, we examine common eye conditions experienced by performing arts professionals.

Floaters – What are they?

In today’s blog we are looking at two common vision complaints, Floaters. When performing on stage under bright lights, floaters and flashes can be especially bothersome. Many of our clients comment that they see floaters, but what exactly is a floater? 

A “floater” is a small spot in your vision that is caused by tiny particles of collagen or protein that form in the jelly-like substance in the centre of the eye. When the jelly-like substance in the eyeball (known as the vitreous gel) changes, shrinks, or becomes more liquid, it causes eye flashes and floaters. The optometrist may sometimes refer to this as posterior vitreous detachment, and it is a regular occurrence as we become older (PVD).

When we see a floater, we are actually seeing the shadow cast on the retina, not the floater itself. As the vitreous diminishes, the gel-like substance becomes stringy, casting shadows on the retina and causing floaters to appear in our field of vision. The retina is a thin layer located at the back of the eye. This layer converts light energy into electrical signals, which are then transmitted to your brain and processed to produce the images we see (our vision).

Floaters come in a variety of shapes and sizes: some are light, others are dark, some are chunky, and still others are stringy. When we try to look at them directly, they appear to dart away from our field of vision. Floaters are more visible when viewed against a bright plain background and on their own are rarely something to worry about. Floaters are much more common than flashes. 

Floaters are common and, in most cases, pose little risk to our vision or eyesight. They usually do not require treatment, but they might occasionally be a symptom of retinal detachment, which is a more serious problem that necessitates medical attention. When the vitreous, which is shrinking, drags on the retina, drawing it away from the back of the eye and effectively tearing it, retinal detachment occurs. Because retinal detachment can permanently damage your vision, it is best to have your eyes checked as soon as possible rather than ignoring the problem and risking vision impairment.

Blurred vision, pain in your eye, a sudden increase in floaters or flashes, the sudden appearance of floaters or flashes, a decline in your central vision, or shading of vision are all signs of a more serious problem.

Why the flashes?

Flashing lights or lightning streaks may appear when the vitreous gel in our eyes pulls on the retina. After being hit in the eye or on the head, many people describe this sensation as seeing “stars.” These light flashes can happen on and off for weeks or months.

Eye flashes appear in our field of vision as dots or pinpricks of light. They come in a variety of shapes and sizes, some of which are wavy, others jagged, and still others which resemble shooting stars.

It is common to see brief flashes of light, and in many cases, there is no cause for alarm. We recommend that anyone experiencing frequent, persistent, or increasing occurrences of eye flashers see an optometrist as soon as possible.

Flashes can occur as a result of the following conditions:

  • Ageing – Causes the vitreous to shrink or change, resulting in flashes of light. The likelihood of seeing light flashes increases with age.
  • Pressure on the retina – Rubbing your eyes too hard or being struck in the eye can cause the vitreous to bump the retina, resulting in eye flashers.
  • Migraine – A migraine can cause vision problems. As part of a migraine, you may experience glinting lights, dots, sparkles, and flashes of light.

Is it a Serious Issue to Have Eye Flashes?

Given how important our vision is to us, it’s natural for us to wonder if our vision is in danger when we see a flash of light in our eye. While many cases of eye flashes are considered normal, they can also be the result of a serious retinal condition.

Tear or Detachment of the Retina

In rare cases, the vitreous can pull the retina so hard that it tears, causing it to peel from its position at the back of the eye. Flashers can be caused by a torn or detached retina.

The sudden onset of new eye flashers, persistent flashers, a floater shower, and flashes of light accompanied by blurry vision are all indications that an optometrist should be seen as soon as possible. To avoid blindness or partial vision loss, retinal surgery or other interventions may be required.

In Summary

The optometrists at Allegro Optical have the technology, facilities, including our fantastic 3D OCT eye scanners, and experience to determine if your eye flashers are serious. Early detection and treatment are critical for preserving your vision, eye health, and performing arts career.

As the UK’s only specialist Performing Arts eye care provider we understand more than most just how much dry eye conditions can impact a performer’s career and everyday life. 

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians using cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve performing arts practitioners’ vision problems. 

If you are suffering from any of the symptoms mentioned above or have any of the symptoms described then please speak to one of our staff.  To book an appointment or find out more about our exclusive dry eye programme, Call us today and speak to a member of our team. 

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/

Categories
Music

#SeeTheMusic and More – Dry eye, it’s a blinking nuisance

Dry eye disorders and the performing arts professional

Being the UK’s only performing arts eye care specialists and the only optician registered with the British Association For Performing Arts Medicine (BAPAM), we understand first-hand how eye disorders can negatively impact a career. 

Artists such as musicians, dancers, singers, presenters and technicians, including camera operators, sound engineers and Audio-visual technicians, are just some of the performing arts professionals we have assisted to see the music.

Almost all of us will experience vision problems at some point in our lives. Refractive errors are responsible for most of these problems, which means they affect the way the eyes focus light, rather than an eye disease or disorder. Nonetheless, many of us could be affected by eye disorders or diseases. In this blog series, we examine common eye conditions experienced by performing arts professionals. 

Here are the five most common eye disorders and diseases:

  • Cataracts are a widely occurring eye problem and usually affect people over the age of 65. Most have a visually impairing cataract in one or both eyes. Cataracts are usually seen as the formation of a dense, cloudy area in the lens of the eye. When this happens, light is simply unable to pass through to the retina and the victim is unable to clearly see objects in front of them.

  • Dry eye disease is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. Some people may experience subtle, but constant, eye irritation to significant inflammation and even scarring of the front surface of the eye. 

In different parts of the world, dry eye syndrome affects anywhere from 5% to 50% of the population. Contact lens wearers are particularly susceptible to the condition. The condition is also common in the elderly.

  • Glaucoma causes damage to the eye’s optic nerve.  In most cases, this is due to fluid buildup and increased internal pressure. This interferes with the transmission of images from the optic nerve to the brain. If the buildup of pressure continues without treatment, it may lead to permanent loss of vision. 

Glaucoma progresses relatively quickly and can cause blindness within a few years. The most common symptoms of glaucoma include tunnel vision, peripheral vision loss, blurry eyes, halos around the eyes, and redness of the eyes.

  • Macular degeneration (AMD) is a condition affecting the central part of your view. It typically affects people in their 50s and 60s. The condition does not cause total blindness. Nevertheless, it can make everyday tasks difficult, such as reading and recognising faces.

Your vision may deteriorate without treatment. AMD can develop slowly over several years (“dry AMD”) or rapidly over a few weeks or months (“wet AMD”).

The exact cause of AMD is unknown. The risk factors include smoking, high blood pressure, being overweight, and having a family history of AMD.

  • Retinal Detachment is precisely what it sounds like. It is the detachment of the retina from its place within the eye. There may be small tears in the retina before the whole retina is detached. If it is left untreated, complete vision loss can occur in the affected eye. It sounds painful, but people rarely feel any pain during retinal detachment.

There are various warning signs that a retinal detachment may occur. These include blurred vision, a sudden appearance of light flashes, and a curtain-like shadow in one’s field of vision.

Dry Eye Disease: An overview

It will never be possible to completely cure Dry Eye, however, we can easily manage and its symptoms are treated and alleviated with a tailored treatment program.

What is Dry Eye?

Dry eyes are caused by either not producing enough tears or tears that are of poor quality or that evaporate far too quickly.  Tears are normally made to keep the surface of the eye moist and lubricated, so a lack of tears or a reduction in the quality can result in gritty, burning sensations in the eyes and also cause vision problems.

Symptoms of Dry Eye

The symptoms of Dry Eye may include:

  • Dryness
  • Burning, stinging or itching
  • Gritty feeling
  • Irritation from wind or smoke
  • Blurred or smeared vision
  • Tired eyes
  • Red eyes
  • Excessive watering
  • Photophobia (sensitivity to light)
  • Contact lens discomfort

Causes of Dry Eye?

  • Ageing
  • Allergies
  • Blepharitis (inflammation of the eyelids)
  • Dry environment and pollution
  • Computer use
  • Visual concentration,
  • Contact Lens wear
  • Hormonal changes, especially in women e.g. menopause
  • Dry Eye may also be symptomatic of general health problems or disease e.g. people with arthritis are more prone to Dry Eye (Sjogren’s Syndrome = arthritis + dry eye + dry mouth)
  • LASIK surgery
  • Preservatives
  • Certain types of medication – your optometrist or GP can advise you of any known links between medicine and Dry Eye.

Performing Arts Professionals and Dry Eye  Disorders

After a rehearsal or a concert, do your eyes become tired and irritated? After playing and reading the music for a while, does it start to look blurry? These are symptoms of dry eye. Having spoken to our clients and measuring their blink rate we have found that about  1/3 of them suffer from varying degrees of dry eye symptoms.

The bright stage lights and dry air found in most rehearsal rooms and orchestra pits, along with the almost constant staring at sheet music adds to the risk of developing dry eyes. Fortunately, there are simple steps you can take to ease its symptoms.

In most cases, dry eyes occur when your eyes do not make enough tears to keep them moist and to wash away dust. Environmental factors also contribute to dry eyes. Performing Arts and media production environments may contribute dry eyes.

Am I at risk of Dry Eyes?

Almost everyone suffers from dry eyes at least once or twice due to allergies, low humidity, or windy weather. Dry eyes are more likely to affect people with certain health conditions, such as autoimmune diseases.

Dry eyes may be caused by an underlying health condition such as diabetes, rheumatoid arthritis, or rosacea.

A dry eye disorder occurs when tear production is too little or when tears evaporate too quickly. In either case, there is not enough fluid in the tears. When tears are insufficient, the surface of the eye can become dry. The tears will also become saltier. This leads to inflammation, discomfort and blurred vision.

As a result of chronic dry eye disease, ocular tissues can become damaged and in severe cases, scarring can appear on the cornea, the clear dome of tissue that covers the front part of the eye. When the damage is severe, it can cause blurry vision or even blindness. It is not uncommon for dry eye disease to affect a person’s quality of life significantly. The effect of chronic, mild or moderate dry eye disease on quality of life can be as significant as breaking a hip due to pain and physical limitations, according to one study in the United Kingdom.

How to look after your dry eyes

The optician will probably start your dry eye care with advice to reduce environmental dryness and shake up your daily routine. The first line of care recommendations might include these tips:

  • Avoid air blowing in or across your eyes: Air conditioners and heaters contribute to dry eye disease. Point fans away from your eyes when inside or driving. In windy weather, wear protective eyewear such as sunglasses. Try using an eye mask or humidifier if you have a heater or fan running during the night while you sleep. Ceiling fans are notorious for drying out your eyes!
  • Blink more often or take an eye break: Our blink rate is lower when we read, play a piece of sheet music, look at a computer screen, or use our smartphones. When performing tasks that require more visual concentration, blink more often or close your eyes for a few minutes periodically.
  • Use artificial tears: Lubrication plays an important role in the treatment of dry eye disease. Preservative-free artificial tears are recommended. Essentially, this is due to the fact that preservatives used to stop bacteria from growing over time can damage the surface of the eye, causing further irritation and redness. A wide variety of pharmacies and supermarkets sell artificial tears that are free of preservatives. Infections can be prevented by purchasing individual vials. The key to artificial tear use is preventing the eyes from feeling dry in the first place, not after they begin to feel dry.
  • Try an eye gel or ointment: Longer-lasting lubrication might be provided by these thicker tears. Because the thickness can blur your vision for 15 minutes or more, you might consider putting them in before bed. If you don’t close your eyes completely during sleep, using gel overnight helps protect your eyes.
  • Use a warm compress:  Warm face cloths and eye masks can help clear blocked oil glands. Apply them for five to ten minutes twice a day. It can be relaxing to do this regularly to maintain your eye health.
  • Lid scrubs: It is important to keep the eyelid area clean in order to help keep the glands healthy. Several pharmacies and supermarkets sell lid scrubs that can be used to remove debris. You should scrub your lids every day and use warm compresses to increase oil production and keep your glands healthy. 

Advanced dry eye therapies

If self-care therapies don’t effectively treat your symptoms, your optician or optometrist might suggest more advanced, nonsurgical treatments, such as:

  • Medication adjustment: There are certain drugs that can worsen dry eye symptoms, including antihistamines, antidepressants, birth control pills, and blood pressure medications. Talk to your GP or pharmacist to find an alternative. Be sure to discuss all medications you are taking with your doctor and continue taking them as prescribed until your doctor recommends a change.
  • Prescription eye drops: Prescription eye drops help increase tear production and reduce inflammation in the eyes if the over-the-counter artificial tears aren’t enough. Ask your GP about a prescription for Hylo Forte if you have a persistent problem
  • Nonsteroidal anti-inflammatory drugs (NSAIDS): The discomfort caused by dry eyes can be relieved with over-the-counter NSAIDs.
  • Steroid eye drops: It is possible to need steroid eye drops for short periods of time when dry eye disease triggers inflammation. Due to potential side effects, these drops should only be used for a short period of time in order to reduce inflammation.

What if none of that works?

For cases of severe dry eyes we can refer to specialists who may recommend one of the following therapies;

  • Specialty contact lenses: The surface of the eye can be protected by certain types of contact lenses. They ensure that the cornea remains hydrated and promote healing. Contact lenses called scleral lenses can be helpful for patients with severe dry eye disease.
  • Eyelid thermal pulsation technology: It may be possible to receive an out-patient procedure if you suffer from meibomian gland dysfunction. A device is placed over the eyelids and heat is applied to soften the hardened oil-like substance. In addition, pulsed pressure is used to open and express the clogged glands. The glands can produce healthy oils once the hardened substance has been removed from the glands, preventing tears from evaporating. This procedure takes about 12 minutes.
  • Intense pulsed light (IPL) therapy: This procedure can be performed as an outpatient procedure for patients with rosacea and meibomian gland dysfunction. The small blood vessels that supply the glands in the eyelids can be treated using a cool laser. Consequently, the inflammation of the eyelids and ocular surface is reduced and healthy lipids that prevent tear evaporation are produced.

In Summary

As the UK’s only specialist Performing Arts eye care provider we understand more than most just how much dry eye conditions can impact a performer’s career and everyday life. 

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians using cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve performing arts practitioners’ vision problems. To help in the treatment of dry eye we have developed a Dry Eye Treatment Programme. This is a management program consisting of:

  • Initial 30 minute consultation with a dry eye specialist Optometrist, followed by reviews within the first 3 month period as necessary
  • Up to 3 appointments with an Optometrist and/or Dispensing Optician throughout the year
  • Preferential discounts of products to manage your condition
  • All this for just £4.99 per month
  • Treatment may consist of:
  • Ocular lubricants
  • Heat treatment
  • Lid massage
  • Lid hygiene
  • Supplements

If you are suffering from any of the conditions mentioned above or have any of the symptoms described then please speak to one of our staff.  To book an appointment or find out more about our exclusive dry eye programme, Call us today and speak to a member of our team. 

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/

Categories
Music

#SeeTheMusic and More – Cataracts, are they clouding your performance?

Cataracts and the performing arts professional

Being the UK’s only performing arts eye care specialists and the only optician registered with the British Association For Performing Arts Medicine (BAPAM), we understand first-hand how eye disorders can negatively impact a career. 

Artists such as musicians, dancers, singers, presenters and technicians including camera operators, sound engineers and Audio-visual technicians, are just some of the performing arts professionals we have assisted to see the music.

At some point in our lives, most of us will have vision problems. The majority of these problems are caused by refractive errors, which means they’re problems with the way the eyes focus light, rather than an eye disease or disorder. However, there are some eye disorders and diseases that many of us could experience. This blog series highlights the common eye conditions that many performing arts professionals encounter. 

Here is our list of the 5 most common eye disorders and diseases:

  • Cataracts

    are a widely occurring eye problem and usually affect people over the age of 65. Most have a visually impairing cataract in one or both eyes. Cataracts are usually seen as the formation of a dense, cloudy area in the lens of the eye. When this happens, light is simply unable to pass through to the retina and the victim is unable to clearly see objects in front of them.

  • Dry eye disease

    is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. Some people may experience subtle, but constant, eye irritation to significant inflammation and even scarring of the front surface of the eye. 

In different parts of the world, dry eye syndrome affects anywhere from 5% to 50% of the population. Contact lens wearers are particularly susceptible to the condition. The condition is also common in the elderly.

  • Glaucoma

    causes damage to the eye’s optic nerve.  In most cases, this is due to fluid buildup and increased internal pressure. This interferes with the transmission of images from the optic nerve to the brain. If the buildup of pressure continues without treatment, it may lead to permanent loss of vision. 

Glaucoma progresses relatively quickly and can cause blindness within a few years. The most common symptoms of glaucoma include tunnel vision, peripheral vision loss, blurry eyes, halos around the eyes, and redness of the eyes.

  • Macular degeneration (AMD)

    is a condition affecting the central part of your view. It typically affects people in their 50s and 60s. The condition does not cause total blindness. Nevertheless, it can make everyday tasks difficult, such as reading and recognising faces.

Your vision may deteriorate without treatment. AMD can develop slowly over several years (“dry AMD”) or rapidly over a few weeks or months (“wet AMD”).

The exact cause of AMD is unknown. The risk factors include smoking, high blood pressure, being overweight, and having a family history of AMD.

  • Retinal Detachment

    is precisely what it sounds like. It is the detachment of the retina from its place within the eye. There may be small tears in the retina before the whole retina is detached. If it is left untreated, complete vision loss can occur in the affected eye. It sounds painful, but people rarely feel any pain during retinal detachment.

There are various warning signs that a retinal detachment may occur. These include blurred vision, a sudden appearance of light flashes, and a curtain-like shadow in one’s field of vision.

Cataracts: An overview…

Cataracts are the result of the crystalline lens, developing cloudy patches. The crystalline lens is an important part of the eye’s anatomy that allows the eye to focus on objects at varying distances. It is located behind the iris and in front of the vitreous body.

These patches tend to grow larger over time, causing blurry, misty vision and eventually blindness.

Our lenses are generally clear when we’re young, allowing us to see through them. As we age they start to become frosted or yellow, like dirty bathroom windows, often severely limiting vision.

It is common for both eyes to be affected by cataracts. That said, they may not necessarily develop at the same time or be the same type of cataract in each eye. They’re more common in older adults and can impact daily activities such as driving. Cataracts can also affect young children and babies.

Seeking medical advice

Consult an optician if any of these symptoms occur:

  • Blurred or misty vision
  • Lights seem too bright or glaring 
  • You have trouble seeing in low light
  • Night driving is difficult
  • Colours appear faded
  • If you wear glasses, you may feel your lenses need constant cleaning, or that your lens coating isn’t working.

Although most cataracts aren’t painful and won’t irritate your eyes, if they’re in an advanced stage or you suffer from another eye disorder, they may cause discomfort.

Performing Arts Professionals and Cataracts

Q: Can Cataracts Affect My Performance?

A:  Cataracts can affect sight-reading and your ability to perform if your vision is affected as a result.  The crystalline lens is similar to the camera lens. Through it, light is focused on the retina for processing as vision. Cataracts form when Collagen, the most abundant protein in the body, builds up on the lens, clouding vision.

As cataracts progress, you may encounter issues with limited vision.  You may have difficulty seeing music on the stand, the accidentals, dynamics or even key signatures. For dancers, dance notation may appear blurred or for production staff problems viewing computer screens may become evident.  As cataracts progress, they can affect more aspects of your day-to-day and performing life if left unchecked.

We find that musicians tend to feel the effects of cataracts sooner than most general practice clients. This is because cataracts cause problems with sight-reading and depending on the type of cataract can appear as blurred patches or discoloured areas across the music manuscript. 

There are 31 types of cataracts, but the 3 main types of age-related cataracts are nuclear sclerotic, posterior subcapsular and cortical. Because they’re grouped by where they form, they present slightly different symptoms, develop at different speeds, and have different causes. They can all cause progressive vision loss, which means the vision gets worse over time.

Nuclear sclerotic cataract

Nuclear sclerosis is the most commonly occurring type of cataract. ‘Nuclear’ refers to it from the nucleus of the lens, while ‘sclerosis’ refers to hardened body tissue. 

Symptoms

It is difficult to focus when you have nuclear sclerosis. As your sight deteriorates, you might experience a temporary improvement in your close-up vision. As your cataract progresses, your vision will deteriorate again. Objects at a distance will appear blurry and colours will appear faded as the lens yellows further.

Cortical cataract

‘Cortical’ refers to the outer layer of something, which describes this cataract as being on the outer edge of the lens,– the opposite of a nuclear sclerotic cataract. A cortical cataract develops spoke-like lines that lead to the centre of the lens, scattering light as it enters the eye.

Symptoms

Your vision may be blurred or you may see blurry lines. You can also experience problems with glare from the sun and artificial lighting, as well as driving at night. Cortical cataracts may develop fairly quickly, with symptoms becoming more apparent within months rather than years.

Posterior subcapsular cataract

They form at the back of the lens – i.e., posterior – in the capsule where the lens sits (subcapsular). Cataracts in this area can produce more disproportionate symptoms for their size because the light is more focused towards the back of the lens. Diabetes or extreme short-sightedness place you at greater risk for a subcapsular cataract. Additionally, if you are exposed to radiation or use steroids, you may develop a cataract of this type.

Symptoms

Under certain conditions, a subcapsular cataract can cause difficulty seeing in bright light and can produce glare or halos around lights at night – so it can be particularly problematic when on stage or when dealing with stage lighting. You may have blurry vision and be unable to read.  Subcapsular cataracts tend to develop faster than both nuclear sclerotic and cortical cataracts.

Performers visual demands

Performers are required to use one or more of the following skills:

  • Rapid changes in focus. Changing focus between objects at different distances rapidly and accurately is vision focusing. A musician, for instance, needs to read the music on the stand, look at the conductor and other members of the ensemble all at different distances clearly and accurately. This can be affected by cataracts as they cause the lens to become stiff, affecting the lenses flexibility and the ability to change focus quickly.
  • Vision fixation: The ability to read sheet music, regardless of how fast its tempo. This also can be affected by cataracts as they cause blurring, glare and patchy vision.
  • Peripheral vision: The ability to see and observe out of the corner of your eye when looking at a fixed object such as sheet music on the stand. In an orchestra, a player must be able to see both their stand partner or another member of their section even when they may be unable to alter their head position due to their instrument.  This can be severely compromised by cortical cataracts that begin on the outside edge of the lens (the peripheral). Cortical spokes, or white streaks or wedge-shaped opacities, progress inward on the lens, impairing vision and obstructing light reflection. 
  • Focusing regulation: The ability to retain eye coordination during high-speed activities or while under high physiological pressure.

The above demands can place a lot of pressure on the performer, especially when their vision isn’t up to par. 

Effective treatment of age-related cataracts

For a while, new glasses and brighter reading lights can ease the symptoms of cataracts. 

However, cataracts do get worse over time, so you’ll eventually need surgery to remove and replace the affected lens.

The only proven treatment for cataracts is surgery. During cataract surgery, an artificial lens replaces the cloudy one inside the eye. The procedure is highly effective at improving vision, but it can take between two and six weeks for vision to be fully restored.

Generally, cataract surgery takes 30 to 45 minutes. It is usually done as a day surgery under local anaesthesia, and you can usually go home the same day. 

Monofocal lenses are offered by the NHS, which have a single point of focus. In other words, the lens will be fixed either for near vision or distance vision, but not both.

If you opt to have your surgery privately, both multifocal and accommodating lenses are available to you, which allow you to focus on both near and distant objects.

Unless you have opted for multifocal or accommodating lenses most people will need to wear glasses for some tasks, like reading, using computers or reading music.

If you have cataracts in both eyes, surgery is done 6 to 12 weeks apart to allow the recovery of one eye at a time.

In Summary

Cataract treatment is beneficial to both performers and amateurs. However, they do have limitations and will not stop the ageing process. We recommend that you continue with regular eye examinations after your surgery, Either every two years or 12 months, as recommended by your optometrists. As performers ourselves our unique perspective enables us to offer balanced, impartial advice on all aspects of cataract treatment.

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians using cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve hyperopic performing arts practitioners’ vision problems.

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/

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Music

#SeeTheMusic and More – Presbyopia and performing arts professionals

Presbyopia and the performing arts professional

In our unique position as the UK’s only eye care specialists working with performing arts professionals, we are well aware of how eye disorders and refractive errors can negatively impact careers. As BAPAM registered practitioners we are using this series of blogs to highlight and explain many common eye conditions that performers face. The performing arts professionals that we have helped include musicians and presenters, dancers and camera operators, sound technicians and singers.

The four most common types of refractive error are:

  • Myopia or Short-sightedness. Myopia results from light focusing just short of the retina due to the cornea or the eyeball being too long.
  • Hyperopia or Long-sightedness. Generally, hyperopia is a result of the eyeball being too short from front to back, or of problems with the shape of the cornea (the top clear layer of the eye) or lens (the part of the eye that helps the eye to focus).
  • Presbyopia or Old Sight. Presbyopia is caused by a hardening of the eyes crystalline lens, which occurs with ageing. As our lenses become less flexible, they can no longer change shape to focus on close-up images.
  • Astigmatism, or rugby ball-shaped eyes. Astigmatism causes blurred distance and near vision due to a curvature abnormality in the eye. A person with astigmatism either has an irregular corneal surface or a lens inside the eye that has mismatched curves. 

In the UK, 61 percent of people have vision problems that require corrective action. Just over 10 percent of people regularly wear contact lenses, and more than half wear glasses. However, not all vision problems are caused by refractive error. In spite of the name, presbyopia is not caused by refractive error, but rather by the hardening of the crystalline lens of the eye as we age. The lenses become less flexible as they age, so they cannot focus on close-up objects.

There are several symptoms associated with presbyopia, including blurry vision, headaches, and difficulty focusing on objects up close. Vision continues to deteriorate as we age. 

Presbyopia and the musician

Presbyopia affects performing arts professionals slowly over time and may present some with career-limiting consequences A performer with presbyopia has difficulty seeing objects that are close to them clearly, from around the age of 50 this includes the music on the stand. Often objects at a distance remain relatively clear unless the presbyopia is combined with another eye condition or refractive error.  The numerous working distances present a variety of challenges to the performer. The need to see the music on the stand is often the biggest issue. Even so, seeing the conductor, the audience, the soloist, and other sections of the ensemble clearly can pose a challenge. 

What causes presbyopia?

As we age, the lens of our eyes becomes less flexible and we have difficulty focusing on close-up objects. Imagine the eye as a camera. Whether an object is near or far, the lens of the camera can autofocus on it. Our eyes work in a similar way. The iris works with our corneas to focus light. Our curved corneas bend light, and then a tiny circular muscle encircling our crystalline lenses contract or relax, causing a change of focus. The muscle relaxes if the object is far away. When something is close, the muscle contracts, allowing us to focus on nearby items such as a book, computer screen, mobile phone or sheet music. However, as we age, our eyes continue to grow and add layers of cells to the lens – a bit like an onion! As a result, the lens becomes thicker and less flexible. Nearby objects are blurred as a result.

#SeeTheMusic and more

The visual demands of performing artists and those who work in production are extremely diverse. Thus, presbyopia can pose some serious challenges. Musicians and presenters must contend with music on the stand or an autocue for the presenter. In the production control room, the production team views multiple screens on a wall of video monitors. The team typically reviews scripts, running orders, production notes and often musical scores as well. Focusing at multiple distances can be challenging in a fast-paced environment such as this.

Musicians and performers often ask us, as performing arts eye care specialists, “What makes their eyes so unique?” Performers’ vision or their eyes aren’t particularly exceptional, but the way they use them is. Artists share many characteristics with athletes when it comes to the many visual demands they are subjected to.

The vision skills required for all sports, both competitive and non-competitive, differ depending on the sport. The same is true for most performers, whether they are professionals or amateurs, what instrument they play and the ensemble they play in. Their role as a performing arts professional presents different challenges, from sound technicians, camera operators, production staff and lighting engineers, they all have multiple viewing distances and visual demands.

Allegro Optical has developed detailed assessments of vision skills for artists and performers of all ages using advanced diagnostic equipment and investigative techniques.

Most performing arts professionals need one or more of the following skills:

  • Vision focusing:

    A capability to change focus quickly and precisely between objects of different distances. Musicians must be able to read the music on the stand, look at their conductor, and see other sections of the ensemble clearly and accurately from different distances.

  • Vision fixation:

    Music reading skills, particularly at a fast tempo and regardless of how fast the music moves.

  • Peripheral vision:

    Observing an object out of the corner of your eye, such as a sheet of music on a stand or a bank of flat or curved screens in a production room. Even when a player is unable to alter their head position due to their instrument, they must still be able to see both their stand partner or another member of their section.

  • Focusing regulation:

    Maintaining eye coordination during high-speed activities or when under high physiological pressure.

Effective treatment of Presbyopia

Spectacles

Presbyopia presents unique challenges for first-time spectacle wearers, such as a reduction in depth of focus when wearing reading glasses. Spectacles used solely to correct presbyopia (reading glasses) have a number of disadvantages, including an enlarged image size or magnification, peripheral distortions, and a reduced field of vision.

All of these present performance-limiting challenges to the performer. As Michael Downes, Director of Music St Andrew’s University said “Things had become more challenging very quickly – until I was 47 or 48 I didn’t have any problems at all, but then they rapidly became severe. The ‘tipping point’ was an April 2019 concert – I realised that unless I did something about it I would no longer be able to carry on doing my job to a satisfactory standard.

Without the help given me by Allegro Optical, I think I would be continuing to have very severe difficulties.”  

Many performing arts professionals turn to varifocals, bifocals or “office” lenses to resolve their vision problems, however all of these lenses present the musician with problems. Even the very best individual designs and “tailor made” varifocal lenses provide a narrow field of clear vision. 

Occupational, “Office” or computer lenses provide a wider field of view, but the depth of field is often limited to 2-4 metres.

Bifocal lenses do offer a limited solution in that the bottom of the lens will magnify the music on the stand and the upper part of the lens provides a clear view of the conductor, however, the wearer does experience two different image sizes. This is known as image jump and it can present problems to some wearers.

Contact lenses

Some performers prefer to use contact lenses, particularly if they find using glasses inconvenient or unattractive.

The lightweight and near-invisible properties of contact lenses make them appealing to performers, but a presbyopic correction can sometimes be less satisfactory if not worn before.  Presbyopic contact lens wearers often complain that they can’t see as well in contact lenses and that their distance vision is compromised.  In addition to a long-wear period and a dry, warm and often dusty environment, wearing contact lenses on stage can also exacerbate dry eyes. Most contact lens wearers experience dry eye symptoms toward the end of the day. Unfortunately, the majority of musicians perform in the evening, so this often coincides with their performances. For musicians, especially those who work as freelancers or session musicians, dry eyes can lead to blurred patches of vision that make sight-reading difficult.

Laser eye surgery

Laser eye surgery is often considered as a way around having to use glasses and contact lenses, we would add a word of caution here for performing arts professionals. We see many clients who come to us a few years after having undergone laser surgery. Most complain that while they can still see well in the distance and for reading, their music reading distance is deteriorating, especially if they have opted for a monovision correction. When performers ask us about laser surgery we usually recommend lens replacement surgery. 

Lens implant surgery

Lens implants are a viable and long-term treatment for presbyopia. A small incision is made in the cornea to implant an artificial multifocal lens into your eye to focus light more clearly onto the retina for all distances.

Also known as Refractive lens exchange (RLE) is an operation similar to cataract surgery in which the natural lens is removed and replaced with an artificial one.

The procedure is typically done under local anaesthesia, and you can normally go home the same day. The procedure is usually done separately for each eye.

In Summary

Both performers and amateurs find many of the optical corrections discussed above to be a viable solution to the problems posed by presbyopia. Some however find the plethora of solutions available on the high street to be far from ideal. 

As performers ourselves our unique perspective enables us to offer balanced, impartial advice, it also allows us to create unique lens designs and optical solutions to correct the vision disturbance presented by presbyopia. 

Our optical specialists understand the demands of professional musicians and performing arts professionals. Working in collaboration with our dispensing opticians and optometrists, we are able to assist musicians. It is surprising how many musicians are unaware of the many solutions available to them. 

With the precision of our performing arts eye exams, the expertise of our optometrists and dispensing opticians and their access to cutting edge diagnostic equipment and dispensing procedures our unique approach can help to resolve hyperopic performing arts practitioners vision problems.

Contact: To find out more about Allegro Optical, the musicians’ opticians go to; https://allegrooptical.co.uk/services/musicians-optical-services/