Risk factors for glaucoma in musicians

Glaucoma is a possibly blinding condition for which early detection and
treatment is warranted. Playing wind instruments, especially high resistance
wind instruments (oboe/bassoon/trumpet/French horn), may predispose the onset
of ocular hypertension (OHT) and glaucoma by increasing intraocular pressure
(IOP). However, evidence concerning the exact relationship between the playing
of wind instruments and the onset of OHT or glaucoma is scarce and the impact
of playing wind instruments on the progression of the disease in patients who
already have glaucoma is not known. Additionally, the magnitude of musicians
who are at risk is not known. Identifying musicians who are at risk for
glaucoma or already have glaucoma and play wind instruments for many hours per
week will promote early and efficient treatment of patients in this particular
population. Studying the amount and mechanism of IOP increase of musicians
while playing their different instruments will lead to a better understanding
of which musicians are at risk for developing OHT and (progression of) glaucoma.
If the hypothesis that wind musicians have a higher risk of OHT and glaucoma
can be proven, the development of a screening program for early detection and
treatment of OHT and glaucoma in wind instrument players can be useful.
Additionally, there is some evidence that visual and other eye problems may
occur quite frequently among musicians in orchestras. For example, uncorrected
refractive errors may lead to early fatigue, painful eyes and headaches. This
has not been investigated in the Netherlands.

With the contact lens device for continuous IOP monitoring, IOP can be
monitored in ambulatory mode and during normal activities (including studying
at home with their instrument, rehearsals, rest, meals, and the sleep period),
in the habitual position of the participants. This will give the researchers
important information concerning the frequency of IOP peaks during the day and
night, from which valuable feedback and advice can be given to the study
participants concerning their risk for the development or progression of
glaucoma.

Primary Objective:
* To study the impact of playing wind instruments for the development of OHT
and (progression of) glaucoma.

Secondary Objective(s):
* To study the risk factors for the development of OHT and glaucoma in
professional musicians.
* To study the prevalence of visual problems and eye diseases in professional
musicians.

Observational study.

There are no risks involved for the participants. Screening for OHT and
glaucoma together with other eye complaints may be very beneficial for the
early diagnosis and treatment of affected individuals and awareness of group
related problems, if applicable.
However, in case an unsuspected eye disease is diagnosed during screening, this
may be a burden to the patient and may cause further difficulties if the change
to take out a policy on health insurance is hampered.

There are no substantial risks expected for the participants who agree to
undergo IOP monitoring over a 24 hour period with a sensing contact lens, which
is pure silicone with an oxygen plasma surface treatment to create a highly
hydrophilic interface between the sensor and all tissues in contact. The device
provides a leven of oxygen permeability equal to or greater than the
recommended boudaries of extended wear to avoid corneal hypoxia. This means
that the cornea is as protected as possible from metabolic stress during the
monitoring period.

A possible burden may be that with the use of the sensing contact lens, an
antenna is placed round the eye, which is connected to a portable recorder
through a thin flexible data cable. The recorder is placed on the chest. The
antenna is visible for other people.