#SeeTheMusic and More – Myopia and performing artists

Myopia and the performing arts professional

In response to our Webinar with BAPAM and the Royal Society of Musicians of Great Britain on the subject of sustaining musical careers, we have decided to post a series of blogs focusing on performing arts eye care. 

As the UK’s only performing arts eye care specialists, we know first-hand how eye disorders can have a detrimental effect on a professional’s career. This series of blogs will highlight the common eye condition which can seriously affect performing arts professionals. From Musicians to Presenters, Dancers to Camera Operators, Sound Technicians to Singers, the list of performing arts professionals who we have helped to see the music and more, is extensive and varied.

Most vision problems are caused by refractive errors. Sixty-one percent of those in the UK have vision problems requiring some form of corrective action, with just over 10 percent using contact lenses regularly, and over half wearing glasses. 

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. 

Myopia: Perspectives and challenges

In this blog, we look at how myopia affects the performing arts professional and how we can resolve this refractive error effectively.

For a performer or performing arts professional a refractive error, eye disease and disorders can have a catastrophic impact on their career. For those working in production, there are many different visual demands. The production control room requires members of the production team to view multiple screens on the video monitor wall. In addition, the team follows a script and or running order and often a musical score. Focal distances can range from infinity to 30cm. In a fast-paced environment such as this, the challenge of focusing at multiple distances can be a problem.

For the musician and performer too, Myopia can present a challenge, from seeing the music on the stand, seeing the conductor, audience, the soloist and other sections of the ensemble. For the myopic musician, the conductor can often be a little blurred and in more extreme cases the sheet music on the stand can appear blurred.

#SeeTheMusic and more

As specialists in the field of performing arts eye care, we are frequently asked “What’s so special about musicians’ eyes?”. In short, there is nothing special about their eyes, but the way a performer uses their vision is. Musicians, performers and performing arts professionals are very much like athletes. 

Good vision skills are necessary for most sports, both competitive and non-competitive, and different sports have specific requirements. The same is true for most performing arts professionals and amateur performers. With the help of advanced vision testing equipment, the team at Allegro Optical have developed detailed assessments of vision skills for performers and performing art professionals of all ages.

So, we hear you asking, “What special vision requirements does a performer need?” Well, it’s one or more of the following skills on display:

  • Vision Focusing: The ability to change focus quickly and accurately between objects at different distances. For example, a musician needs to read the music on the stand, look at their conductor and other sections of the ensemble all at different distances clearly and accurately.
  • Vision fixation: The ability to read sheet music, often at a fast tempo, no matter how fast it’s moving.
  • 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.
  • Focusing regulation: The ability to retain eye coordination during high-speed activities or while under high physiological pressure.

Effective treatment of Myopia

Spectacles

When wearing spectacles, myopia presents unique challenges, as peripheral vision is often impaired. The disadvantages of spectacles for myopia correction include reduced retinal image size, peripheral distortion, and a reduced effective field of vision. All of which presents the performer with performance-limiting challenges.

Thinned lenses are popular among myopic spectacle wearers who aim to improve the appearance of their glasses. Nevertheless, the denser lens materials can produce unwanted chromatic aberration.  Chromatic aberration occurs when a lens is unable to focus all colours onto the same focal point, causing distortion of the image.  In turn, this causes the perception of undesirable colour fringes. 

Contact lenses

Contact lenses provide a viable alternative correction of myopic errors where spectacle wear can be a hindrance. Performers often choose contact lenses over glasses because they’re lightweight and almost invisible, but some find them uncomfortable or more of a hassle. Also wearing contact lenses for long periods of time and in dry and warm environments, such as on stage, can also exacerbate dry eyes. Symptoms of dry eyes are most frequent toward the end of the day, when patients experience the most symptoms. Unfortunately, this tends to coincide with most musicians’ performances, which are often late in the evening. Dry eye can lead to blurred patches of vision, making sight-reading problematic, particularly for the freelance or session musician.

Laser eye surgery

During laser eye surgery, small sections of your cornea are burned away to create a more focused beam of light on your retina.

Laser eye surgery can be divided into three main types:

Photorefractive keratectomy (PRK)involves the removal of a small amount of corneal tissue and reshaping the cornea using a laser to remove tissue and change its shape

Laser epithelial keratomileusis (LASEK) is similar to PRK, but involves using alcohol to soften the corneal surface to facilitate the removal of a flap of tissue and repositioning it afterwards, while a laser is used to change the shape of the cornea.

Laser in situ keratoplasty (LASIK) – similar to LASEK, except that a smaller corneal flap is created

In most cases, these procedures are performed on an outpatient basis. Local anaesthesia is used to numb your eyes while the procedure is performed, which usually takes less than 30 minutes

LASEK or LASIK are usually the preferred methods because they are virtually painless, and you will usually be able to see them again within a few hours or days. However, it may take a month for your vision to fully stabilise.

Lens implant surgery

Another viable treatment for short-sightedness is lens implant surgery. The procedure involves implanting an artificial lens into your eye through a small incision in the cornea.

The lenses are specially designed to focus light more clearly onto the retina.

People who are very short-sighted or who have difficulty wearing glasses or contact lenses can benefit from this procedure.

Lens implants fall into two categories:

Phakic implants are artificial lenses that are placed into your eye without removing your natural lens; they are generally preferred by younger people with normal natural reading vision

Refractive lens exchange (RLE) is the surgical removal of the natural lens and replacement with an artificial one, similar to cataract surgery.

The implants are typically inserted under a local anaesthetic and you can usually leave the hospital the same day. Each eye is usually treated separately.

Can myopia get better?

As children grow, myopia tends to worsen.

Myopia worsens as people age, usually faster and more rapidly when they are young, than in adulthood.

When you reach the age of 20 or so, myopia usually ceases to worsen.

As of now, no single treatment appears to be able to stop this progression.

Treatments involving eye drops containing atropine or special contact lenses may slow the progression.

According to research, atropine eye drops can slow the progression of myopia, but may cause side effects at high concentrations (such as trouble reading and sensitivity to bright light).

In the UK, low-strength drops are not commercially available.

In Summary

All the above treatments offer potential solutions for performing arts professionals and amateurs. However all the above do have limitations and side effects. As performers ourselves we are able to provide balanced and impartial advice from a unique perspective.

We have a  team of optical professionals who understand the demands of professional musicians. By working together our teams of dispensing opticians and optometrists are able to assist musicians in overcoming these difficulties so that their working and playing lives can be improved.

Many myopic musicians are unaware of the many solutions to their vision problems. Now thanks to our specialised performing arts eye exams, our optometrists’ broad knowledge, our cutting edge dispensing procedures and unique lenses these problems can be overcome.”

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

Alternatively call Greenfield 01457 353100 or Meltham 01484 907090  

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