Introduction to Sports Vision and Foundation of Vision Therapy

Wiboon Tantirittisak, MD. Watanee Jenchitr, MD. Faculty of Optometry Rangsit University

Visual Training and Sport Vision

is the branch of optometry concerned with vision and perception, evaluating and enhancing visual performance, and prescribing, where necessary, the most appropriate visual aids. Sports vision is a term which encompasses the assessment, correction and enhancement of vision as well as the protection of eyes during sporting activity. Anyone who has problems with vision while participating in sport would be well advised to consult an SV practitioner. practitioner.

What is Sports Vision Training?

Sports vision services typically include: include: - Detection of visual problems that can affect performance. - Correction of visual acuity and refractive error problems. - Enhancement of ocular skills through vision training. - Protection from ocular injury. - Assessment and management of any sportssportsrelated ocular traumas that may occur. occur.

 The basic premise of sports vision is that the eyes feed information to the brain, which interprets it and then activates the arms, hands, legs, feet, and balance system. system.  This happens within a fraction of a second, over and over again for the duration of the game. game. When the eyes message is inaccurate, incomplete, or not delivered at the correct time, performance can suffer. suffer.

Goals and Expectations

Eye health to providing protective eyewear to prevent any eye trauma during the game; providing contact lenses or goggles to protect from ultraviolet (UV) radiation; or providing punctal plugs to enhance the tear layer and prevent dryness during an athletic event. Refraction to provide the proper refractive correction that will allow the athlete to function with maximum visual acuity and contrast sensitivity. Familiar with all types of sensitivity. vision correction including glasses, sports goggles, sports specific contact lenses, corneal refractive therapy/ therapy/orthokeratology, and refractive surgery. And to surgery. know the advantages and disadvantages of each of these modalities for each sport in which the athlete might participate. participate.

 Identify Problems - to provide a series of tests that will help to identify certain visual conditions that may be affecting performance during a game. Will help to determine whether an athlete has a visual performance weakness. These tests need to evaluate: visual acuity, contrast sensitivity, depth perception, eye-hand-foot eye-handcoordination, ocular motilities, accommodative flexibility, peripheral awareness, peripheral reflexes, speed and span of recognition, anticipation timing, and visual concentration.  Interpretation of Information Interpretation of information obtained from testing is critical in determining whether the athletes eyes are affecting or limiting performance. performance. To provide sports vision enhancement training to the athlete. A structured training or athlete. enhancement program is a definite part of the overall services that a sports vision office needs to provide. provide.

Vision Therapy
 Optometric vision therapy is recommended when the visual problem cannot be solved with environmental changes or lenses only.  The procedures, which may involve using specialized instruments, are individualized based on the visual skill level of the patient.  The vision therapy program begins where the patient is. This is usually at a basic level.  As the patient and the therapy progresses, the therapy becomes more complex and intense.

Optometric Vision Therapy Evaluation

 To determine if Optometric vision therapy is appropriate for a patient, an extensive evaluation is performed. This evaluation includes not only the determination of someones visual acuity (sight) at both distance and close and refractive error (existence and amount of nearsightedness, farsightedness or astigmatism) but:

 Depth perception  Color vision  Ability to follow an object (oculomotor skills or eye tracking skills)  Ability to use both eyes together at both distance and near (binocular or eye teaming skills)  Ability to focus or see clearly at near (accommodation)  Ability to sustain near focus and eye teaming skills at near

Additional testing may include:  Developmental testing of motor abilities such as balance  Eye-hand coordination  Visual perceptual abilities  Visual memory abilities  Figure ground testing  Visual auditory integration tests  Further testing to determine ability to improve eye alignment if an eye turn or lazy eye exists.  Developmental testing of ability to know ones own right/left.

Why do sports vision screening?

 30% had less than 20/20 vision 30% 20/  25% had decreased depth perception 25%  26% had poor eye-hand coordination for 26% eyethe demands of their sport  12% had inaccurate eye movement 12% abilities

Sports Vision Evaluation

 Begins with a determination of the refractive error (nearsightedness, farsightedness or astigmatism) which may be reducing visual acuity.  Proceeds to the evaluation of focusing, tracking, binocular and other dynamic visual skill.  Eye health is completely evaluated both externally and internally

The visual skill necessary for peak athletic performance in many sports are:
 Dynamic Visual Acuity - the ability to see objects clearly that are in motion  Eye Tracking - the ability to keep your eye on the ball  Eye Focusing the ability to change focus from one object to another quickly and clearly.  Peripheral Awareness being able to see things out of the corner of your eye.

 Depth perception the ability to quickly and accurately judge the distance and speed of objects.  Eye-Hand or Eye-Body Coordination the ability EyeEyeto use our eyes to effectively direct the movements of our hand/body.  Accommodation/Vergence the ability to efficiently change eye focusing and eye aiming when looking between objects at different distances.  Visual Concentration this is the ability to focus your attention on the athletic task while filtering out peripheral distractions.  Visualization involves picturing different parts of your activity in your minds eye while your eyes are seeing and concentrating on something else.