Musicians and Glaucoma

[bobd0]

This subject came up during a recent eye exam. I searched the forum but didn't find anything on it, so here's the scoop from an article I found at The Associated Musicians of Greater New York -- with a good explanation of how the eye works and the effects of playing high-resistance brass instruments on intraocular pressure (IOP).

http://www.local802afm.org/2000/05/glau ... musicians/

Archive: Volume C No. 5 May, 2000
Glaucoma – an Occupational Hazard For Musicians?
by Robert Ritch, MD, FACS

Prolonged high expiratory air resistance, such as is experienced by professional brass musicians, may be a risk factor for the development of glaucomatous optic nerve damage.

And the same conclusion from the NIH.

http://www.ncbi.nlm.nih.gov/pubmed/21234587

CONCLUSIONS:
The temporary and sometimes dramatic elevations and fluctuations in IOP observed in this study, coupled with daily exposure to instrument play, puts professional wind instrument players at increased risk of developing glaucoma. Consequently, these musicians should be monitored for signs of glaucoma, especially those with co-existing risk factors.

So, if you didn't know it already, those yearly visits to the eye doctor are even more important for brass players -- more often for long-time and/or older players, since the effects are cumulative.

[tbn.al]

As a brass musician for the last 58 years I am eye to eye with this problem. Glaucoma something we all need to be aware of. Probably 30 to 40 percent of my sight reading errors are a result of eye trouble. Those yearly eye exams are critical for me. Don't neglect your eyes folks.

[bighonkintuba]

Interesting...

Here's a link to the full Schmidtmann et al. article (a Scottish/German research group; this does not appear to be a study sponsored by NIH, which provides access to research article abstracts through the PubMed search engine; NIH did not present conclusions in this case):
http://www.academia.edu/4471080/Intraoc ... _condition" target="_blank

Page 898 has suspect data analyses:
Correlation between blood pressure and intraocular pressure: 'small, but mostly non-significant correlations'

Correlations between data sets are either significant at the pre-selected (before the study even begins) alpha value or they aren't. There is no 'mostly' in correlation or any other statistical analysis. I would dismiss this article and would have rejected it as a reviewer for that brief 'analysis' alone. Studies that report specific p values for individual statistical tests are poorly regarded. We simply report the significance threshold value and the result of the test (e.g., p < 0.05 or not). Experimental data sets cannot be more (as suggested misleadingly by reporting particularly low p values) or less significant than others. That's not how statistics works. A difference is either significant or it's not.

They differentiate between high (trumpet; horn) and low (trombone; tuba) resistance brass instruments and present data suggesting that high resistance instruments produce higher intraocular pressures at 'middle' and 'high' frequencies, but don't indicate whether or not this is supported by a statistical analysis (though they do report mean +/- standard error), which is suspicious. They don't present all of the data for individual instruments, which is important. Also, what are the real (i.e., measurable) differences in resistance between trumpet and horn; trombone and tuba etc. and how does measured resistance influence anatomy/physiology in real-time? I suspect that trumpet + horn (and trombone + tuba?) were combined to inflate sample sizes (n). What's really strange is that they show individual means +/- standard error for the low resistance instruments (they are effectively the same but, which is for trombone and which is for tuba?) at middle/high frequencies even though they combined the sample according to the previous sentence.

There may very well be a connection between increased intraocular pressure and playing a brass instrument, but I would discount this research as the article has serious issues.

But... thanks for the reminder to call for my yearly eye exam appointment!

[bobd0]

My doctor's opinion was that IOP increase is temporary. My previous ophthalmologist said the same. I looked it up out of an overabundance of caution and found the brass references. My pressure is OK but I have to have it checked every six months for other reasons. Good I reminded you!