Skip to main content

Advertisement

SpringerLink
Log in

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

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pizzarello L, Abiose A, Ffytche T, Duerksen R, Thulasiraj R, Taylor H, Faal H, Rao G, Kocur I, Resnikoff S (2004) VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol 122:615–620

    Article  PubMed  Google Scholar 

  2. Sultan MB, Mansberger SL, Lee PP (2009) Understanding the importance of IOP variables in glaucoma: a systematic review. Surv Ophthalmol 54:643–662

    Article  PubMed  Google Scholar 

  3. Nassr MA, Morris CL, Netland PA, Karcioglu ZA (2009) Intraocular pressure change in orbital disease. Surv Ophthalmol 54:519–544

    Article  PubMed  Google Scholar 

  4. Morrison JC, Nylander KB, Lauer AK, Cepurna WO, Johnson E (1998) Glaucoma drops control intraocular pressure and protect optic nerves in a rat model of glaucoma. Invest Ophthalmol Vis Sci 39:526–531

    PubMed  CAS  Google Scholar 

  5. Heijl A, Leske MC, Bengtsson B, Hyman L, Hussein M (2002) Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 120:1268–1279

    PubMed  Google Scholar 

  6. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO (2002) The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 120:701–713, discussion 829-730

    PubMed  Google Scholar 

  7. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121:48–56

    PubMed  Google Scholar 

  8. Johnson EC, Cepurna WO, Jia L, Morrison JC (2006) The use of cyclodialysis to limit exposure to elevated intraocular pressure in rat glaucoma models. Exp Eye Res 83:51–60

    Article  PubMed  CAS  Google Scholar 

  9. Nickells RW (2007) From ocular hypertension to ganglion cell death: a theoretical sequence of events leading to glaucoma. Can J Ophthalmol 42:278–287

    Article  PubMed  Google Scholar 

  10. Nickells RW, Schlamp CL, Li Y, Kaufman PL, Heatley G, Peterson JC, Faha B, Ver Hoeve JN (2007) Surgical lowering of elevated intraocular pressure in monkeys prevents progression of glaucomatous disease. Exp Eye Res 84:729–736

    Article  PubMed  CAS  Google Scholar 

  11. Leske MC, Warheit-Roberts L, Wu SY (1996) Open-angle glaucoma and ocular hypertension: the Long Island Glaucoma Case-control Study. Ophthalmic Epidemiol 3:85–96

    Article  PubMed  CAS  Google Scholar 

  12. Bulpitt CJ, Hodes C, Everitt MG (1975) Intraocular pressure and systemic blood pressure in the elderly. Br J Ophthalmol 59:717–720

    Article  PubMed  CAS  Google Scholar 

  13. Klein BE, Klein R (1981) Intraocular pressure and cardiovascular risk variables. Arch Ophthalmol 99:837–839

    PubMed  CAS  Google Scholar 

  14. Klein BE, Klein R, Knudtson MD (2005) Intraocular pressure and systemic blood pressure: longitudinal perspective: the Beaver Dam Eye Study. Br J Ophthalmol 89:284–287

    Article  PubMed  CAS  Google Scholar 

  15. Bouhuys A (1964) Lung volumes and breathing patterns in wind-instrument players. J Appl Physiol 19:967–975

    PubMed  CAS  Google Scholar 

  16. Fiz JA, Aguilar J, Carreras A, Teixido A, Haro M, Rodenstein DO, Morera J (1993) Maximum respiratory pressures in trumpet players. Chest 104:1203–1204

    Article  PubMed  CAS  Google Scholar 

  17. Schorr-Lesnick B, Teirstein AS, Brown LK, Miller A (1985) Pulmonary function in singers and wind-instrument players. Chest 88:201–205

    Article  PubMed  CAS  Google Scholar 

  18. Herer B (2001) Music and respiratory pathology. Rev Mal Respir 18:115–122

    PubMed  CAS  Google Scholar 

  19. Borgia JF, Horvath SM, Dunn FR, von Phul PV, Nizet PM (1975) Some physiological observations on French horn musicians. J Occup Med 17:696–701

    PubMed  CAS  Google Scholar 

  20. Dimsdale JE, Nelesen RA (1995) French-horn hypertension. N Engl J Med 333:326–327

    Article  PubMed  CAS  Google Scholar 

  21. Faulkner M, Sharpey-Schafer EP (1959) Circulatory effects of trumpet playing. Br Med J 1:685–686

    Article  PubMed  CAS  Google Scholar 

  22. Harris LR (1996) Horn playing and blood pressure. Lancet 348:1042

    Article  PubMed  CAS  Google Scholar 

  23. Larger E, Ledoux S (1996) Cardiovascular effects of French horn playing. Lancet 348:1528

    Article  PubMed  CAS  Google Scholar 

  24. Elghozi JL, Girard A, Fritsch P, Laude D, Petitprez JL (2008) Tuba players reproduce a Valsalva maneuver while playing high notes. Clin Auton Res 18:96–104

    Article  PubMed  Google Scholar 

  25. Rosen DA, Johnston VC (1959) Ocular pressure patterns in the Valsalva maneuver. Arch Ophthalmol 62:810–816

    PubMed  CAS  Google Scholar 

  26. Schuman JS, Massicotte EC, Connolly S, Hertzmark E, Mukherji B, Kunen MZ (2000) Increased intraocular pressure and visual field defects in high resistance wind instrument players. Ophthalmology 107:127–133

    Article  PubMed  CAS  Google Scholar 

  27. Abraham AG, Condon NG, West Gower E (2006) The new epidemiology of cataract. Ophthalmol Clin North Am 19:415–425

    PubMed  Google Scholar 

  28. Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP (2005) Smoking and age-related macular degeneration: a review of association. Eye (Lond) 19:935–944

    CAS  Google Scholar 

  29. Lee AJ, Rochtchina E, Wang JJ, Healey PR, Mitchell P (2003) Does smoking affect intraocular pressure? Findings from the Blue Mountains Eye Study. J Glaucoma 12:209–212

    Article  PubMed  Google Scholar 

  30. Morgan RW, Drance SM (1975) Chronic open-angle glaucoma and ocular hypertension. An epidemiological study. Br J Ophthalmol 59:211–215

    Article  PubMed  CAS  Google Scholar 

  31. Reynolds DC (1977) Relative risk factors in chronic open-angle glaucoma: an epidemiological study. Am J Optom Physiol Opt 54:116–120

    PubMed  CAS  Google Scholar 

  32. Wilson MR, Hertzmark E, Walker AM, Childs-Shaw K, Epstein DL (1987) A case-control study of risk factors in open angle glaucoma. Arch Ophthalmol 105:1066–1071

    PubMed  CAS  Google Scholar 

  33. Katz J, Sommer A (1988) Risk factors for primary open angle glaucoma. Am J Prev Med 4:110–114

    PubMed  CAS  Google Scholar 

  34. Klein BE, Klein R, Ritter LL (1993) Relationship of drinking alcohol and smoking to prevalence of open-angle glaucoma. The Beaver Dam Eye Study. Ophthalmology 100:1609–1613

    PubMed  CAS  Google Scholar 

  35. Quigley HA, Enger C, Katz J, Sommer A, Scott R, Gilbert D (1994) Risk factors for the development of glaucomatous visual field loss in ocular hypertension. Arch Ophthalmol 112:644–649

    PubMed  CAS  Google Scholar 

  36. Stewart WC, Crinkley CM, Murrell HP (1994) Cigarette-smoking in normal subjects, ocular hypertensive, and chronic open-angle glaucoma patients. Am J Ophthalmol 117:267–268

    PubMed  CAS  Google Scholar 

  37. Kang JH, Pasquale LR, Rosner BA, Willett WC, Egan KM, Faberowski N, Hankinson SE (2003) Prospective study of cigarette smoking and the risk of primary open-angle glaucoma. Arch Ophthalmol 121:1762–1768

    Article  PubMed  Google Scholar 

  38. Grewal RK, Karalekas DP, Kraff C, Hawkinson DW, Krupin T (1995) Intraocular pressure change with increased pulmonary outflow. Investig Ophthalmol Vis Sci 36:295–387

    Google Scholar 

  39. Schwab B, Schultze-Florey A (2004) Investigations into intraoral pressure in woodwind and brass musicians. Musikerphysiologie und Musikermedizin 11:183–194

    Google Scholar 

Download references

Acknowledgement

We would like to thank Graeme Kennedy for helpful comments on the manuscript. Results of this paper were partly presented at the International Congress on Music Physiology and Musician Medicine 2009 (Freiburg, Germany).

Author information

Authors and Affiliations

  1. Department of Vision Sciences, Glasgow Caledonian University, Cowcaddens Road, G4 0BA, Glasgow, Scotland

    Gunnar Schmidtmann

  2. Course of Optometry, University of Applied Sciences Luebeck/Fielmann Akademie, Schloss Plön, Plön, 24306, Germany

    Gunnar Schmidtmann & Hans-Jürgen Grein

  3. Optometry and Vision Science, University of Applied Sciences, Carl-Zeiss-Promenade 2, 07745, Jena, Germany

    Susanne Jahnke & Wolfgang Sickenberger

  4. Department of Physical und Rehabilitation Medicine, The Liszt School of Music Weimar, Institute of Musician’s Medicine and Music Physiology, Henry-van-de-Velde-Straße 2, 99425, Weimar, Germany

    Egbert J. Seidel

Authors
  1. Gunnar Schmidtmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne Jahnke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Egbert J. Seidel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wolfgang Sickenberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hans-Jürgen Grein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gunnar Schmidtmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schmidtmann, G., Jahnke, S., Seidel, E.J. et al. Intraocular pressure fluctuations in professional brass and woodwind musicians during common playing conditions. Graefes Arch Clin Exp Ophthalmol 249, 895–901 (2011). https://doi.org/10.1007/s00417-010-1600-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-010-1600-x

Keywords

Search

Navigation