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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/

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About Allegro News

An introduction to Glaucoma by Optometrist Amy Ogden

Amy Ogden Optometrist

What is glaucoma?

Amy Ogden, Optometrist at Allegro Optical Opticians in Saddleworth and Holmfirth, explaines why she likes the 3D OCT scanner so much

Glaucoma is the name used for the group of eye conditions which cause damage to the optic nerve. This damage can ultimately cause sight loss. Our optic nerve is the wire that connects the brain and the eye together. It sends visual information from one to the other.

There is a misconception that glaucoma is one disease, when actually there are many different types. I will touch upon a few below. 

Types of glaucoma 

Primary open angle glaucoma (POAG) 

This is the most common type of glaucoma, characterised by elevated intraocular pressure and an open anterior chamber angle with no other underlying pathology. Some of the risk factors for this include; increasing age, higher intraocular pressures (checked with the puff of air test), being of Afro-Caribbean descent, being short sighted and having a family history of POAG. 

Open angle glaucoma

In early stages, most people with POAG don’t have any symptoms. They are only diagnosed as part of their routine sight test, which is why it is important to keep up to date with regular sight checks. Those in late stages of POAG may notice a restricted visual field and blurred vision.

Normal Tension Glaucoma 

This is a type of POAG, however in this type of glaucoma, there are no raised intraocular pressures (IOP). Although there are no raised IOPS, there is still damage to the optic nerve, retinal nerve fibre layer thinning and visual field loss ( we can use the OCT machine and the visual field screener, along with ophthalmoscopy to help identify this). Some of the risk factors for this type of glaucoma include; those with the higher-normal level IOPS; those patients with history of stroke or diabetes (any ischemic vascular disease) and those with Raynaud syndrome – this is commonly linked to migraine.

Congenital Glaucoma

This is high IOP within the first year of life. Blindness occurs in 5/50 of all cases and reduced vision in 20/50 of all cases, it is rare, and only occurs in 1/10,000 births.

Juvenile Glaucoma

This is a very rare type of glaucoma in those individuals aged between 3 and 40. It is genetic and early onset in nature. It is not very responsive to medication and often requires surgical intervention, as it has a very rapid progression

Acute Angle Closure Glaucoma ( AACG)

Closed angle glaucoma, this happens when there is a sudden rise of intraocular pressure, which can cause damage to the optic nerve.  This is usually caused by the pupil blocking the drainage channel of the eye ( in most cases), and in the case of Primary AACG, eyes which suffer from this type of condition are anatomically different from those which don’t, putting them at a much higher risk. They tend to be shorter, have thicker lenses – which are positioned further forward in the eye, and the cornea ( the window which covers the coloured section of the eye), tends to be flatter. 

Closed angle glaucoma

Some other risk factors for this type of glaucoma include; being long sighted, having a family history of this type of glaucoma, increase in age, being female, being of Asian or Inuit descent.

Secondary AACG is when trauma or eye disease can cause the pressure in the eye to raise.

Secondary glaucoma

This occurs secondary due to an underlying healthy or eye condition. Types of secondary glaucoma can include –

Pigment dispersion syndrome and pseudoexfoliation

this is where the pigment from the back of the iris, is rubbed off by the front of the lens. This pigment then deposits itself in the drainage channel, eventually blocking the outflow of the fluid in the eye ( aqueous humour ), this leads to high pressure. In pseudoexfoliation, the drainage channel is blocked with a dust like substance. The dust comes from the surface of the lens capsule which is rubbed off by the continuous movement of the iris, when the pupil changes size.

Iatrogenic glaucoma

Iatrogenic means caused by a medical professional, for example during surgery, or due to steroid use.

Uveitic  Glaucoma

Uveitis is when the pigmented tissues of the eye ( the Uvea) become inflamed. It usually affects those from ages 20-59. There are different types of uveitis Anterior, Posterior and Intermediate all categorised based on which part of the uveal tract is being affected.  The way in which uveitis can cause glaucoma is numerous; the inflammatory byproducts of fluid and protein may leak into the drainage channel and block fluid outflow; Uveitis can cause secondary angle closure glaucoma due to the inflammation in the front part of the eye; Uveitis is often treated with steroids. It is this steroid use which can lead to high IOPS and damage to the optic nerve. 

Cataract

When cataracts become very advanced, they can swell and block the outflow of fluid through the eye, and cause a secondary angle closure effect. 

Trauma

Being hit in the eye may cause high pressure though inflammation ( uveitis ), Bleeding ( haemorrhage blocking the drainage channel), dislodging of the lens in the eye.

Chemical burns can cause inflammation  uveitis) 

Blunt force trauma can cause the drainage angle to be pushed backwards, and over a number of years, there is a pressure build up/ development of high pressure. 

Drug related 

Steroids cause the pressure in the eye to raise, and although they can be injected, inhaled, taken orally, used topically on the skin or eye, the most common way to cause IOP raise is by application locally to the eye. This is when a steroid is applied onto or around the eye, either by injection, or eye drop.  This is why those people who are using eye treatment containing a steroid, should have their eye pressures checked on a regular basis.

Neovascular  glaucoma

 this can occur when due to certain eye conditions ( such as diabetic retinopathy ), new blood vessels are created. These are small and leaky. They can grow into the surface of the eye, but also into the drainage channel, and block it, causing a raise in IOPS

There are several other reasons for secondary glaucoma, but these are just a few examples.

Are there any signs of glaucoma?

For NTG and PAOG usually no, not in the early stages. AACG does cause symptoms and can be extremely uncomfortable. I have listed some of the glaucoma warning symptoms below

  • Gradual blurred vision, starting in the periphery ( outer edges)
  • Seeing halos around bright lights
  • Severe pain in the eye and frontal headache, a very red, sore eye, and nausea/vomiting

How is glaucoma detected?

Glaucoma is detected usually following a routine sight test. We check intraocular pressures using our pressure test, we can check the peripheral field of vision using our field screening test, we do a thorough examination using the slit lamp of the front and the back of the eye to look at the drainage channel and at the optic nerve using volk. We also carry out a OCT 3D scan if requested, and this can detect glaucoma up to 4 years early. 

If raised IOPS are suspected we carry out repeat pressure reading; as checking pressures at a different time of day, on a different day, can also affect the measurement of IOP we obtain.

If glaucoma is suspected, an onward referral to the hospital eye clinic for further investigations

How is it treated?

The aim of the ophthalmologist and hospital optometrist is then to manage the underlying cause and prevent any further damage to the optic nerve. Some of these treatments include:

  • Eye drops
  • Laser treatment – iridotomy, a small hole is made in the iris to help with drainage of fluid
  • Trabeculectomy – this is where a new drainage channel is made to improve fluid outflow 

… and Finally

Damage to the optic nerve can not be reversed, and glaucoma is the second leading cause of blindness worldwide, with around 60 million people living with it. 

Damage to the optic nerve can however, be prevented if detected and treatment is sought at an early stage. Make sure you attend your regular sight tests, and if you have any concerns ring your optometrist for advice.