My Retinal Romance

Music and medicine have been intertwined since the ancient Greeks – but how can music be used to aid ophthalmology? Music has been shown to act as a calming influence that can ease patients through difficult diagnostic procedures and even surgery. Listening to music affects the brain and can co-opt the body’s perception of pain and reduce anxiety levels – which has obvious advantages during eye surgeries (1). On top of this, it can help ophthalmologists relax and concentrate, so why not hook up your latest playlist to the operating room speakers?

Spare the pain

Pain is based on perception as well as the activation of pain receptors – and perception can be manipulated by playing music for auditory stimulation, thereby dulling the sense of pain. “Distractions” such as playing music, interacting with the patient during surgery, or touch can help reduce patients’ pain levels.

Anxiety, which may worsen pain, can be appeased with music that relaxes patients. The thought of undergoing surgery is often a major cause of stress and anxiety even before factoring in the fear of being conscious during a procedure, which can exacerbate patients’ anxiety and pain perception. The noises of the operating room are also a major source of anxiety, and playing music can cover the sound of equipment and the conversations between operating staff.

So what songs should you be playing to reduce patients’ anxiety and pain? Research indicates that, for intravitreal injections (because needle penetration of the globe of the eye can cause a lot of unease and discomfort), Relaxing Piano: Studio Ghibli Complete Collection and a variety of Mozart’s music lowered pain and anxiety scores in patients when played before and during the surgery (2,3).

Another stress-inducing operation, cataract surgery, is often performed in older patients who commonly have lower pain tolerance and higher anxiety levels due to the increased rates of comorbidities and complications during surgery. For this procedure, Korean traditional music – a simple melody without lyrics played on traditional Korean zithers and an electronic keyboard – reduced pain scores in patients (4).

But not all research has shown a positive effect; one study into PRP laser treatment of patients with diabetic retinopathy showed that a variety of classical music had no effect on pain perception (5).

Team players

The other side of the coin is music’s effect on the operating team. Although one study found no positive effects on hand tremors or surgical precision from listening to Mozart’s sonata for 2 pianos in D-K448, it did indicate that listening to music during operations was not detrimental to surgical performance (6) – a win for any operating music buffs!

What about non-ophthalmologist operating room staff? It seems they favor music during surgery, claiming that it improves mood and cognitive function and allows them to perform calmly and thoughtfully during stressful procedures. Tracks over 60–80 beats per minute are a no-go, though; such music was found to work people up too much, causing increased heart rate, blood pressure, and respiratory rate (7). It’s also clear that loud music is unpopular, with 59 percent of respondents preferring medium- and 41 percent preferring low-volume tunes. Other concerns include not being able to hear key information (such as a patient’s breathing), music being a nuisance in emergency scenarios, and unnecessary distractions and time-wasting when trying to find the perfect cataract track (7,8).

Nonetheless, although music alone won’t heal patients’ vision, it is clear that it offers potential advantages in clinical settings for reducing pain and anxiety. Just be sure to keep the noise down so that you can hear what’s going on – and stay away from inappropriate lyrics!