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.
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:
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.
Music reading skills, particularly at a fast tempo and regardless of how fast the music moves.
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.
Maintaining eye coordination during high-speed activities or when under high physiological pressure.
Effective treatment of Presbyopia
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.
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.
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.
Christmas is a time to spend with our loved ones, and New Year is generally a time for reflection and resolutions. For The Allegro Optical family New Year 2021/22 was no different. We took the opportunity to refurbish both our practices. It was a real family affair with everyone getting stuck in.
Helen dealt with getting all the equipment wired back in, Stephen showed off his wallpapering skills. Zac, who turned out to be a dab hand at DIY, installed our new units. Both Myself and Sheryl (Mum) painted the practices. Even our youngest family members got involved with Matthew and Finley playing the piano to accompany us as we worked. We were joined by Dispensing Optician Kim who, as it turns out, is a bit of a whizz at edging.
At times this refurbishment felt like an overwhelming task to attempt and accomplish within a week. However, we all pulled together and each and every day I was amazed at the fruits of our labour. With us all working together it didn’t feel so daunting and we accomplished so much in such a short amount of time.
Looking at both Greenfield and Meltham, the preparation, planning and work has all been worth it. I am incredibly proud of what we achieved. We all love the warmth and family feel of each practice. I feel that the practices look both modern and homely, with a warm inviting atmosphere that is only enhanced by the members of staff in each practice.
We have always strived to deliver excellence in our eyecare services. Not only do we use all the latest equipment such as OCT, which takes a 3D scan of the eyes, but we also offer more specialist services such as colorimetry which allows us to test for visual stress, and Eyewear Styling to help our clients find the perfect pair of spectacles.
As we look back on what can only be considered another strange year, we’re reviewing the past 12 months. We all started the year glad to see the back of 2020, because let’s face it who would want to go back there again!
2021 began in tiers, we started the year in tier 4 and the North of England experienced another mini lockdown as the infection rate continued to rise.
A new year and a new face
In spite of the pandemic, Allegro Optical continued to grow and in March Charlene Bradford joined the team. Charlie joined the team from hearing care provider Amplifon and with her came a wealth of knowledge.
Spring was music to our eyes and ears
By the spring we were seeing a return of our musical clients as many musicians returned to performing as theatres and concert halls reopened. It was so good to feel nearly normal again and get back to enjoying helping performing artists to #SeeTheMusic.
Helping front line workers
While we were busy helping musicians and performers, Dispensing Optician Kim was busy working her socks off providing the frontline staff of NHS mid-Yorkshire Trust with prescription safety goggles. Starting with just the one hospital, Pinderfields General Hospital, the project has since grown to include Kirklees and Calderdale trust and Leeds St James’s University Hospital.
An eye on the future
In May, we installed a new OCT machine in Greenfield, making Allegro Optical the ONLY optician in Saddleworth & Meltham to have this hospital grade technology. Taking care of your eyes is now so much easier with our new 3D Ocular Coherence Tomography scanner. It is not available on the NHS, but it is available to NHS patients for a small extra fee.
An OCT scan can help detect sight-threatening eye conditions earlier. It is possible to detect glaucoma up to four years sooner. Greenfield’s resident Optometrist Sara was over the moon to be able to provide cutting-edge eye care to the people of Saddleworth. Sara commented that she is pleased to now be offering OCT scans as part of eye exams. “OCT adds great value to our optician service, since it enables us to detect and manage conditions with a level of diagnostic capabilities that previously couldn’t be achieved without visiting a hospital,” Said Sara. Detecting these conditions early is the key to helping manage them or referring patients for treatment”.
More new faces
As the year progressed we continued to grow and in July and August, Trainee Optical Assistant Rebecca and Optometrist Liz joined the team. Both young ladies are keen pianists and Liz is also a talented clarinettist.
August was also a month of celebration as Allegro Optical was again named as SME News, West Yorkshire’s Most Trusted Family Run Eye Care Clinic for the second year running.
As a family we usually mark Yorkshire day on the 1st August every year and this year it was particularly special.
October was all ears
During October, the focus was on hearing care and ear wax removal. Hearing care professionals Audiologist Farzana and Registered Nurse Harriet joined the Allegro Optical family providing Ear Wax removal services such as irrigation and microsuction.
As a result of GPs no longer offering ear syringing, the Ear wax removal service addresses a more prevalent problem in the community than you might think. Harriet has a background in community nursing of more than 10 years and is putting the techniques she has learned to good use. An audiologist by training, Ferzana says her job is a perfect blend of clinical and social aspects. Both ladies work in Meltham and Greenfield, and they are always willing to assist when needed.
Saving the best till last
In true Hollywood style 2021 saved the best till last when our very own Kim Walker won the prized title of Dispensing Optician of the Year at the Opticians Awards gala dinner in Mayfair. The award is Allegro Optical’s second Opticians Awards win in three years, which recognises excellence in the UK’s optical industry.
Safety eyewear specialist Kim Walker was shortlisted for this award, one of our industry’s most prestigious in October. Still not quite sure the win really has happened Kim said “It was a privilege to be shortlisted let alone win, I feel truly humbled and this is one the highlights of my life.”
What ever next?
As we write this blog, we are experiencing a sense of déjà vu, with new restrictions and COVID-19 measures looming after Christmas, many of us are thinking “Here we go again”. The last thing we want to do is return to 2020.
During the holiday season, we will let our team enjoy some family time and a well-deserved break. We won’t rest on our laurels while they recharge their batteries. Our Greenfield practice in Saddleworth as well as our founding store in Meltham, Holmfirth will undergo renovations and enter the New Year with a new look and cutting-edge equipment. Watch this space!
We are absolutely delighted to announce that our Dispensing Optician Kim Walker has won the prized 2021 UK Optician Awards Dispensing Optician of the Year Award. Kim’s contributions during the COVID-19 pandemic are acknowledged by this award.
In addition to her work in practice Kim and her colleagues have been dispensing prescription safety eyewear to frontline NHS staff at Calderdale and Huddersfield NHS Foundation Trust, Mid Yorkshire Trust Hospitals, and St James’s University Hospital Leeds. Kim has worked tirelessly for the past year to provide as many frontline NHS staff as possible with prescription eye protection as they battle the COVID-19 pandemic.
Kim worked long hours in practice and at the Hospitals, seeing up to 50 patients a day. Even on her day off, she has gone to work and often stayed overnight due to bad weather. Often under challenging conditions, Kim has dispensed and fitted over 2000 pairs of safety glasses to NHS frontline workers, completing over 4000 appointments. Kim has been emotionally drained at times, but ever the professional, she has not let that affect her work.
An eye on the prize
Even though Kim felt a little overwhelmed by the honour, she and Allegro Optical are thrilled to be recognised nationally once again in this way. When asked about her award Kim said ““It was a privilege to be shortlisted let alone win, I feel truly humbled and this is one the highlights of my life.”
This latest national award is a testament to Kim’s professionalism, experience, dedication, continued high level of service delivery, and Allegro Optical’s use of cutting-edge technology.
Technology and Professionalism
Allegro Optical we pride ourselves on combining award-winning customer service with cutting-edge technology, including optical coherence tomography (OCT) scanners in both Meltham and Greenfield. With OCT imaging the Allegro Optical eye care professionals can detect signs of serious eye conditions up to 4 years earlier than with traditional methods.
We have just invested in Clinical Eye Trackers for both practices, another first in the area. Allegro Optical Optometrists and Dispensing Opticians now have a new tool to evaluate and test eye movements and binocular vision. This allows the team to provide clients with the best optical solutions in the area.
In addition to OCT and Clinical Eye Trackers, both practices now have colorimeters which are used to assess symptoms of visual stress, and other conditions including migraine, photo-sensitive epilepsy or acquired brain injuries. A grand reopening will take place in January 2022 to unveil the new equipment and the new refit.
We are very proud to represent Holmfirth and Saddleworth nationally and continue to provide a high level of service to their loyal and local customers.
1- 3 Station Street, Meltham, West Yorkshire HD9 5NX