#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/

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