Playing Music Despite Macular Degeneration

by Thomas A. Green
Thomas A. Green with Macular Degeneration uses foot switch for computer enlarged music.

Picture: The author (front) is shown playing in the ensemble at the Fall Workshop of the Albuquerque Recorder Society. On the computer screen is the music, which the computer has enlarged to the point where he can read it. A tap of a foot switch brings the next measures of the piece into focus.


My experience of the onset and worsening of macular degeneration while learning to play recorders is described. As my eyesight failed, the need for better illumination and enlarged music eventually led me to create a system for reading very enlarged music from a laptop computer screen. A foot switch connected to the computer is used to advance from one page of music to the next as I play. The system, which works quite well for me now, is described, and the story of its use to continue playing is told. It is partly the story of how, stumbling around in the computer school of hard knocks, one can eventually come up with something useful. For more details, including illustrations and various approaches to enlarging music, see this site's Low Vision Page.

Like many of my recorder playing friends, I came to the recorder as part of a lifelong love of playing music. I started playing the trombone in Junior High School and played constantly until the end of Graduate School. Then the demands of a career in physics caused me to stop playing. Much later, in Albuquerque where I now live, I studied the string bass and played it in the Albuquerque Lesser Symphony Orchestra (ALSO) for a number of years. Now retired and in my late seventies, I have found that the recorder is a lovely and rather difficult instrument to play.

I bought a soprano recorder in 1998 and was later invited to play in the Commodious Consort, a friendly group of intermediate players. In January of 1999 I was diagnosed with macular degeneration. This didn't seem too serious at the time. My right eye was bad but my left eye was still pretty good. In the spring of 1999 I started playing the alto recorder It was possible to compensate for my vision loss at home and during the weekly meetings of the recorder group by attaching one and then two and eventually three 40 to 60 Watt stand lights to a Manhasset music stand. I also started to enlarge my music from 8.5x11 in. to 11x17 inches, using automatic enlargement at a copy center. The tenor and bass recorders were added to my family of recorders about this time.

In the spring of 2000, despite my use of extension cords which made me less able to change rooms during rehearsals than the other students, I was welcomed into the Early Music Ensemble (EME) Course at the University of New Mexico. With its very good players and inspiring teachers, the course was an exciting challenge for me. I also started taking recorder lessons from MaryAnn Shore, a wonderful musician and teacher. In the fall I enrolled in the EME Course again, relying on my music stand lighting and 11x17 in. music.

Over Christmas my left eye deteriorated seriously, and I had to drop out of the spring semester EME class after a couple of meetings. I also had to stop playing in the Commodious Consort, and I discontinued my recorder lessons. My recent and happy re-entry into amateur music was cut short - a depressing state of affairs. It was becoming clear that I needed greater enlargement of my music, and that with sufficiently great enlargement an unmanageable page turning problem was going to develop. There would be just too much paper music to cope with, even on the two music stands I had already tried in private.

Most of my reading and desk work were being done with an Aladdin Classic reader, which displays greatly enlarged images on a screen about the size of a laptop computer. This reader is an enormous advance over the use of magnifying lenses to read pages of text. The screen is very bright, the magnification is very large, and one can sit back and read in relative comfort instead of peering into a six-power lens in indifferent lighting. However, the reader is not portable. When portability is required, magnifying lenses are essential. In using the computer I rely on the Windows Magnifier. It is a movable window, of adjustable size and magnification, which displays the region around the mouse cursor or text input cursor. In most versions of Windows, It is located at Start/Programs/Accessories/Accessibility/Magnifier. I rely on it to see the smaller things on the computer screen clearly.

Around this time I heard about the Sibelius music notation computer program, and was told by their technical support group that in Sibelius one could enlarge and reformat music. The music would be entered into Sibelius through the keyboard or by scanning. The enlarged music made with Sibelius was just as big as the highly magnified text on my Aladdin Classic reader. With one huge measure in a Sibelius window in landscape format, a sixty measure piece (about one regular page of a recorder part) had 60 pages! With enlargements of this magnitude, the use of paper music is very problematic. Four 11x8.5 inch sheets can be pasted together to make a "big page" that fills the music stand, and with somewhat smaller enlargement, two measures of music can be put on one page. In this way a 16 measure piece can be placed on two music stands.

It was evident to me that the pages should be turned within Sibelius using a foot switch. I searched in vain for a music foot switch among the hundreds of foot switch providers on the internet. Then a friend said he had seen an add somewhere, so I persevered. Finally the X-Keys programmable USB foot switch showed up. When pressed and released it could make a left click wherever the mouse cursor was placed. All that was needed, but missing from the Sibelius window where the music is displayed, was a page advance button. I wrote Sibelius about this in February, 2001. This was the beginning of a correspondence with Sibelius which continued through August 2002.

On July 4, I sent an e-mail to David Goldstein, Director of the National Resource Center for Blind Musicians, telling him about my vision problem and asking him about page turners. He replied the same day and referred me to the National Library Service of the Library of Congress. His opinion that there was room for invention in the area of visual aids for people like myself was very encouraging. Since that time David has been a constant source of encouragement as I reported my progress to him. The culmination of our correspondence has been a plan to report the results of my work on a page of his web site,

Later in the summer of 2001 I bought the ToolsworksAS macro writing computer program and by fall had used the program to write a macro (a little computer program) designed to produce a page advance in Sibelius. A "click" of the foot switch started the execution of commands that produced the desired page advance in Sibelius. "Foot clicking" didn't appear to be too difficult. My dream of a way to see and play music was realized for the first time. In November a laptop computer was purchased. The laptop sat on my music stand and was connected to the foot switch on the floor by a USB cable. I was very happy to be ready to start playing music with my friends again.

At this point the central problem of reading music from a computer screen had to be faced. How hard and time consuming is it to get the music into the computer in the first place? This study continues with every new piece of music that is enlarged. About 75 recorder parts have been enlarged thus far. The short answer is that about two hours, more or less, are needed to produce my part for a short piece by direct entry from the keyboard. Music entry by scanning can be quicker in the most favorable cases.

By January 2002 I was ready to rejoin the Commodious Consort, and had decided to concentrate on the bass recorder. There was a big backlog of photocopied music to enlarge. Because photocopies may not scan as well as new music, it seemed like a good idea to order new music to work with. Unpleasant surprise! Some new music cannot be scanned. Both Stan Smith of the Arcadian Press and Richard Geisler have sent me MIDI or Finale computer music files when it turned out that some of their new music could not be scanned. What a friendly thing to do.

Our group played a couple of benefits in which I read my music from the fifteen-inch laptop, using my page-turning macro and the foot switch. All went well. However, at our first performance for the Albuquerque Recorder Society (ARS), the group and audience had to wait while two computer lockups caused me to restart the computer twice before we could start playing. I was very embarrassed, and no one said a word to me afterwards. On another occasion the computer was on too long between our warm up and the performance in church, and it turned itself off just as we started playing. I played Licori by memory that time for better or for worse. Memory serves well when I get ahead or behind in turning pages with the foot switch, as sometimes happens. Continued reliability problems with my system made me accept the fact that a method based on the simultaneous functioning of three computer programs - Toolsworks, my macro, and Sibelius - was not a good idea.

In the fall of 2002 I called the technical support group of the Finale music notation computer program. Finale has page advance and retreat buttons in its music display window. The foot switch could interact directly with these buttons. Only one computer program would be involved. A technical support person told me that, as regarded music enlargement, I could do in Finale what was being done in Sibelius. After verifying this, I moved all my Sibelius files to Finale via MIDI music files and re-enlarged and edited them in Finale. I needed and received almost daily help from the friendly members of Finale's technical support group. The ideal music enlargement and display program for me had been found, and the reliability of my system was guaranteed.

This development encouraged me to take the next step. After playing in a session of the Albuquerque Recorder Society workshop in November, I started playing at the monthly ARS meetings. This more formal setting requires the Society's cooperation, since I must obtain the music at least a week ahead of the meeting in order to enlarge my parts and practice them. This necessary extra effort has been graciously made. I owe special thanks to our ARS president for organizing the process of getting music to me.

At the December ARS meeting, a serious problem emerged. I couldn't jump to new measures fast enough during rehearsal to keep up with the conductor. A few times it was necessary to sit and wait while the others played. This was not fun.

Over Christmas, using the newer computer program, Macro ToolsworksAS, I wrote a macro which allows me to jump to an arbitrary new measure with just a few keyboard entries and no mouse moves. The macro moves the mouse cursor around in the Finale window as needed. With this macro I can keep up with the conductor almost all of the time. Another macro was also written to speed up the change from one piece of music to the next during concerts, where time is of the essence. Although three computer programs must once again work together, their relationship is now such that the occasional problem which arises is quickly and easily corrected.

One last development in my system has occurred. The width of the 15 in. laptop screen causes sixteenth notes with accidentals to sometimes get squashed together. Also, a battery-operated laptop screen isn't as bright as an LCD flat panel monitor with its separate power supply and extension cord. Thus, in the latest model, a 19 in. flat panel monitor, without its base, is placed on the music stand where the sheet music usually goes. The laptop computer now sits on a shelf mounted on the pole of the music stand. The new monitor affords a 23% increase in measure length as well as substantially increased brightness. A circular base makes the music stand and its contents stable against tipping over. Mike Frasier made the all aluminum shelf and gave it to me, one musician to another. With its shelf and base, the stand weighs ten pounds. The electronic equipment in a canvas bag, along with one or two recorders, weighs about thirty pounds. I can still go from the car to rehearsal in one trip, but do notice the added weight.

My son Stuart made a great improvement in the macros by writing them entirely in terms of keyboard shortcuts and commands. In this approach no page advance button is needed for page turning and the macros no longer depend explicitly on the location of menus on the computer screen. Had I known what he knew when I started, the lack of a page advance button in Sibelius would not have presented a problem.

My next step in performance (in 2004) was to join the ARS recorder orchestra. Its director, Ray Hale, welcomed me into the group and gave me the music ahead of time so it could be enlarged. There was so much music, especially in the beginning, that I started using a professional transcriber to make Finale files for me. It was a challenge and a pleasure to play with this group until spring of 2006. At that time advancing age caused me to limit myself to playing with the Commodius Consort. Now (August 2007) mesothelioma appears to promise an unexpected end to my playing days.

With the web site I have hoped to find others with low vision to participate in this ongoing experiment. I am happy to report that several musicians have successfully used or are successfully using the system.

In closing, I wish to thank my wife, Jeannine, and my son, Stuart, for their constant support and encouragement.

[Editor's Note: Tom Green passed away in the fall of 2008. Since the system described is based on readily available parts and existing software, anyone with some technology know-how can set it up. Support, tutorials, and guidance in determining whether the system will work for a given individual may be had by contacting Andy English at Additional illustrations and details may be found on the low vision web page at

At this particular stage, development is not ongoing, but we expect that there will be news and updates to report from time to time. These will be added to the Low Vision Page.]

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