Intraocular pressure fluctuations in professional brass and woodwind musicians during common playing conditions.

BACKGROUND: We investigated the effects on intraocular pressure (IOP) and blood pressure (BP) of playing brass and woodwind instruments by monitoring IOP and BP in a representative group of professional musicians under a variety of common playing conditions. METHODS: IOP and BP measurements were recorded from 37 brass and 15 woodwind instrument players, before and after playing tones of low, middle and high frequency. We also measured IOP and BP before and during playing common exercises of 10 minutes duration, as well as after playing a sustained high-pitched tone, to test for changes in IOP under conditions of maximum effort. RESULTS: Playing tones on brass and woodwind instruments causes a temporary elevation in IOP and BP, depending on the tone frequency: brass instrument players showed a significant elevation after playing high and middle frequency tones (p < 0.0001) whereas woodwind instrument players showed a significant increase only for high frequencies (e.g., oboe, 17 ± 2.9 mm Hg to 21 ± 4.4 mm Hg; p = 0.017). Playing a typical exercise of 10 minutes temporarily increased IOP in both groups of musicians. Finally, playing a sustained tone of high pitch caused a significant elevation in IOP in brass instrument players only (16.6 ± 3.5 mm Hg to 23.3 ± 8.9 mm Hg; p < 0.0001). 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

The effectiveness of questionnaires in the determination of Contact Lens Induced Dry Eye

Purpose: This study investigates how well the recently introduced Ocular Comfort Index (OCI) and the more established McMonnies Dry Eye Index are able to detect contact lens induced dry eye (CLIDE). Methods: Seventy volunteer contact lens wearers (mean age = 28.7 ± 8.0; 52 female, 18 male) were grouped as CLIDE positive or CLIDE negative depending on three sets of criteria: Method I: objective (tear meniscus height, lid parallel conjunctival folds, phenol red thread test and tear break-up time); Method II: objective and/or subjective [contact lens dry eye questionnaire (CLDEQ)] (i.e. being positive by Method I and/or Method III); Method III: subjective (CLDEQ). Symptoms were measured using the McMonnies Dry Eye Index and the OCI. Discrimination was analysed by the receiver operating characteristic (ROC) curves; positive predictive values (PPV) and cut-off values were calculated. Results: ROC results for Methods I and II were statistically significant only for the McMonnies (p = 0.008; p < 0.001; respectively). In Method III ROC results were statistically significant for both the McMonnies (p = 0.001) and OCI (p = 0.005). The McMonnies showed the best prediction of Method I [0.646/10.5 (PPV/cut-off value)], while the OCI gave the best predictability in Method III only (0.518/30.6). Conclusion: A McMonnies scoring of ≥10.5 or an OCI scoring of ≥30.6 indicates CLIDE. The McMonnies performs better in prediction of CLIDE than the OCI

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers.

PurposeTo determine associations for contact lenses (CLs) and meibomian gland atrophy in a matched-pair study.MethodsContact lens wearers (case) and age- and sex-matched non-contact lens (NCL) wearers with no history of CL use (control) were recruited for a multicenter study. All subjects were administered the Ocular Surface Disease Index questionnaire and a comprehensive battery of clinical tests (e.g., tear breakup time, bulbar and limbal redness, meibography, etc.) were performed. Upper and lower eyelid meibomian gland atrophy were graded with both digital meibography (percent gland atrophy) and visual meiboscore methods. Conditional logistic regression analyses were then used to determine relationships among CL use, meibomian gland atrophy, and ocular surface signs and symptoms.ResultsA total of 70 matched pairs were analyzed. The mean (± SD) age of the CL group was 30.6 (± 12.4) years, and that of the NCL group was 30.1 (± 12.2) years. The subjects were 63% female. The association between CL wear and meiboscore was not significant univariately, but the best-fitting multivariate regression model showed that higher meiboscores were associated with being a CL wearer (odds ratio [OR], 2.45) in a model that included eyelid margin erythema (OR, 0.25) and lissamine green staining (OR, 1.25). Percent gland atrophy was not associated with CL wear in regression analysis (p = 0.31).ConclusionsThis study determined inconclusive associations with CLs and meibomian gland atrophy. This study also provided a comprehensive assessment of differences between CL and NCL wearers

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers.

PurposeTo determine associations for contact lenses (CLs) and meibomian gland atrophy in a matched-pair study.MethodsContact lens wearers (case) and age- and sex-matched non-contact lens (NCL) wearers with no history of CL use (control) were recruited for a multicenter study. All subjects were administered the Ocular Surface Disease Index questionnaire and a comprehensive battery of clinical tests (e.g., tear breakup time, bulbar and limbal redness, meibography, etc.) were performed. Upper and lower eyelid meibomian gland atrophy were graded with both digital meibography (percent gland atrophy) and visual meiboscore methods. Conditional logistic regression analyses were then used to determine relationships among CL use, meibomian gland atrophy, and ocular surface signs and symptoms.ResultsA total of 70 matched pairs were analyzed. The mean (± SD) age of the CL group was 30.6 (± 12.4) years, and that of the NCL group was 30.1 (± 12.2) years. The subjects were 63% female. The association between CL wear and meiboscore was not significant univariately, but the best-fitting multivariate regression model showed that higher meiboscores were associated with being a CL wearer (odds ratio [OR], 2.45) in a model that included eyelid margin erythema (OR, 0.25) and lissamine green staining (OR, 1.25). Percent gland atrophy was not associated with CL wear in regression analysis (p = 0.31).ConclusionsThis study determined inconclusive associations with CLs and meibomian gland atrophy. This study also provided a comprehensive assessment of differences between CL and NCL wearers