There are plenty of obvious injuries that can result from repetitive music practice and playing. Carpal tunnel, tinnitus, and neck pain are just a few injuries musicians should look out for. One commonly overlooked problem area is the tool used to read music—the eyes.

Factors that put musicians’ eyes at risk for injury and strain include focusing on small notes on a page for long periods of time, frequent reading with inadequate light, dry eyes, and playing loud and high pitched notes on wind instruments, which can double eye pressure.

The eyes weren’t meant to repeatedly scan small text such as musical notes for an extended length of time. Doing so overworks the muscles in the eyes to the point where they begin to spasm and cause vision to blur. This is called eye strain and it can sometimes lead to ocular migraines

Prevention is the best way to curb eye strain. One simple way to relieve stress on your eyes is to blink or carry eye drops. When the cornea becomes dry, the eye begins to ache. Blinking lubricates them. If you wear contact lenses, you are more susceptible to dry eyes. Consider wearing your glasses to gigs or when you rehearse. Also, be mindful of having proper light and taking appropriate resting breaks when your eyes begin to fatigue.

Janet Horvath of Local 30-73 (St. Paul Minneapolis, MN), author of Playing Less Hurt: An Injury Prevention Guide, and associate principal cellist for the Minnesota Orchestra, says a major cause of eye strain stems from the strenuous, uncomfortable positions musicians sit or stand in when playing in a group or with a music stand. Horvath suggests, when practicing at home or with a group or orchestra, make sure the room is brightly lit; that you aren’t too far away from the sheet music; and that you aren’t craning your neck to see the pages.

If you practice with a music stand, be sure to adjust it to eye level or slightly below and place it where you won’t have to turn your body or crane your neck to see the notes. Maintaining a neutral head and neck position is a key element to reducing the occurrence of eye strain. If you share a music stand with another musician and are used to craning your neck to one side, try switching places to create a better balance. “Studies show there is a higher rate of astigmatism in musicians,” says Horvath. “Some musicians often have to play in chronically asymmetrical positions and the amount of eye movement and head movement when tracking an object, like notes on a page, should be balanced.”

Those who wear corrective lenses should consult an optometrist or ophthalmologist on what types of product is most helpful for a particular performance situation. Horvath actually brought along her stand and a page of sheet music to her eye doctor appointment to illustrate the distance at which her eyes had to work when playing with the orchestra. “If you can take the instrument, that’s even better,” says Horvath. “The doctor wouldn’t know it’s quite a few feet away, it’s not book reading distance and not long driving distance.”

Horvath recommends progressive lenses for musicians in their 40s and 50s. These “allin- one” lenses pack every scenario, reading, driving, and watching TV, into one convenient pair and lack the lines that bifocals and trifocals have.

Since space issues are a common problem in orchestras, it’s important to make your conductor and orchestra aware of any discomfort or difficulty seeing the sheet music. Work with your stand partner to find the best placement of the music, where it is comfortable for both of you. Sometimes, simply turning a chair in a different angle is preferable and works better than twisting your pelvis, core, or neck to view the sheet music. “The most important thing is figuring out your head and neck angle and how you are tracking the music,” says Horvath. “This is essential to avoid injury to body, spine, and shoulders too.”