Sports Vision

Vision Care for the Enhancement of Sports Performance

Graham B. Erickson

• Publisher: Elsevier
• Year: 2020
• ISBN:
  9780323755443
• Edition: 2
• Topic: Medicine
• Subtopic: Opthalmology & Optometry

From basic eye care services to visual performance training, this evidence-based resource explores a range of sports vision services, including assessment and treatment procedures, outcome expectations, and applications to a variety of sports. Optometrists, ophthalmologists, and sports medicine practitioners will find a thorough review and discussion of the role of vision care in an athlete's performance, as well as practical recommendations for applying current research findings to clinical practice.

• Contains practical, clinically oriented chapters on visual assessment, prescribing, and ocular injuries in athletes.
  
  

• Takes a task analysis approach allowing the reader to develop solid reasoning skills and evaluate information needed for clinical practice.
  
  

• Includes a new chapter on Assessment and Management of Sports-Related Concussion.
  
  

• Features visual aids throughout including photographs, tables, and boxes to help clarify and visualize important concepts.
  
  

• Addresses sports vision training approaches and updated digital options reflecting the collaboration between athletic trainers, optometrists, and ophthalmologists in helping optimize vision in athletes.
  
  

Chapter 1: Introduction to Sports Vision

Abstract

In the world of sports, pursuit of optimal performance is pervasive. This chapter provides an overview of vision services designed to optimize visual performance factors for sport applications. Terms used for these services are defined, and the variety of services that encompass sports vision are described. A historical perspective of sports vision is provided, along with an overview of some emerging trends for these services. A clinical care model of evaluation, correction, protection, remediation, and enhancement approaches is highlighted. This chapter provides an introduction and a framework for the chapters that follow.

Keywords

Enhancement training; Sports vision; Vision skills; Visual performance

Have you ever wished you could improve your batting average, lower your golf score, or just play your favorite sport better? Most people who participate in sporting activities love to win or at least improve their performance. Athletes at all levels of competition spend a substantial amount of money on sports, including equipment and clothing. Yet many performances that fail are not caused by poor equipment or clothing, or even by the wrong physical movement, but by the movement being performed at the incorrect time or in the incorrect place.

A significant percentage of the general population in developed nations participate at some level in sporting activities. The National Sporting Goods Association produces yearly estimates of participation by sport and gender for the United States (available at www.nsga.org). The eye care practitioner must recognize that sports participation crosses all lines of age, gender, race, and socioeconomic status; every patient is potentially a sports vision patient. In addition, a significant percentage of the population may not actively participate in sports but are avid spectators.

Considerable debate has taken place concerning the role of vision in sports. Vision is the signal that directs the muscles of the body to respond. The legendary football coach Blanton Collier is credited for developing the concept that “the eyes lead the body.” ¹ Vision provides the athlete with information regarding where and when to perform. Superior size, strength, speed, and agility cannot completely make up for inefficient processing of visual information. For example, if the eyes do not tell a batter where the ball is heading and when it will arrive, he or she is not going to hit it no matter how perfect the swing is. Even for the discriminating spectator, excellent visual function allows improved opportunity to enjoy watching sports. Little debate exists that vision is a critical factor in sports performance; however, even when conflicting evidence is taken into consideration, research clearly shows that successful athletes typically possess superior visual function that allows them to see and perform better than novices in sports.

The athletic community should be educated about the aspects of vision that potentially affect sports performance. To clearly communicate these aspects, the following visual elements should be discussed:

1. • Sight: The clarity of the image on the retina and ocular health.
2. • Motor/sensory: Fixation stability and eye movements, accommodation, vergence, and fusion; visually guided motor performance.
3. • Information processing: Quick and accurate visual processing, interpretation, and decision-making.

Understanding the relevance of these aspects to performance provides an avenue for effective communication of specific vision care recommendations. A better-informed sports community benefits by improved access to services that potentially make sports and athletic competition safe, enjoyable, and more successful.

Overview of Terminology

The term sports vision has been used to describe many vision care services provided to athletes. Practitioners working in this area are usually involved with one or more of the following professional activities ² :

1. • prevention and management of sports eye injuries;
2. • assessment and remediation of functional vision inefficiencies that may negatively impact competitive consistency;
3. • specialized contact lens services with emphasis on environmental factors in sports, position of gaze factors, emergency care, and attainment of optimal visual acuity;
4. • performance-based ophthalmic eyewear services that address visual and environmental demands;
5. • assessment of specific sports-related visual abilities;
6. • enhancement training of specific visual abilities considered to be essential for competitive consistency for a specific sport activity;
7. • consultation with athletes, coaches, trainers, and teams regarding visual factors and strategies related to consistent peak athletic performance.

Many in the global community are dedicated to the pursuit of athletic excellence. A critical but often neglected aspect of peak human performance is vision. The information presented in this book should help stimulate the inclusion of these specialized services in the care of athletes, no matter the level of sports participation.

In North America, the term sports vision has been associated with vision therapy designed for the enhancement of sports performance. The areas of sports vision defined earlier clearly demonstrate that many of these services are basic primary vision care services that are modified to address specific task demands. All eye care practitioners should consider visual performance factors when providing vision care services to athletic patients.

Historical Perspective

The use of special eyewear for sports is perhaps the oldest application of vision factors to performance. Daland described the early use of stenopeic slit masks by Eskimos for hunting, ³ and many other special-purpose optical appliances have been described in the literature. ⁴ Optical protection from solar radiation and glare has been used to some degree for centuries. The use of optical refractive compensation for sports has not been as frequently used, most likely for a combination of practical and aesthetic reasons. The available eyewear was not typically appropriate for use in sports. Contact lens technology did not emerge as a reasonable option for most athletes until the latter half of the 20th century, and refractive surgery options did not become advantageous until the late 1990s. Today, the benefits of significant advances in technology and designs for the correction and protection of vision are enjoyed by athletes (see Chapter 6).

The evaluation of vision skills in athletes has also been an area of intense interest. The earliest literature citation found is an account of the sensory and motor abilities of the legendary baseball player Babe Ruth in 1921. ⁵ This report was followed later by an article discussing the role of vision in baseball. ⁶ These early articles produced suggestions for procedures to assess performance potential in baseball on the basis of vision skill analysis. Interestingly, debate in the literature exists concerning the actual vision profile of the great Babe Ruth. Despite the early report that Ruth had eyesight that was 12% faster than the average person, ⁵ a 1991 article reported that an ophthalmologic examination revealed amblyopia ex anopsia in his left eye. ⁷ The potential role of depth perception in batting is challenged by these discrepancies in Ruth's visual status; either he performed so well because he had superior vision skills or he was successful despite having degraded stereopsis as a result of amblyopia. Although no definitive resolution can be made from these contradictory reports, some have speculated that the unilateral vision loss was likely the result of a complication of his nasopharyngeal carcinoma rather than an undetected congenital condition. ⁸ The exact role of vision in sports performance is still hotly debated, and many vision evaluation procedures have been suggested over the years in an attempt to discover the nature of this aspect of sports performance.

Because vision skills are generally recognized as a critical element to most sport performances, significant interest has been expressed in improving sports performance by using training procedures to enhance vision. Many of the visual attributes that have been identified as important in sport are amenable to training. The relevant questions are whether sport-specific visual abilities can indeed be trained and whether any improvements in visual skills transfer to improved sports performance by the athlete. Although the literature has few reports supporting sports vision training, and these reports often have significant flaws, enhancement of visual skill performance can be logically predicted to provide the athlete with a potential advantage when preparing for a competition.

The increasing interest in sports and the role of vision in sports has produced the impetus for the formation of organizations to facilitate professional communications. The United States was the first to form an entity through the establishment of the Sports Vision Section of the American Optometric Association (AOA) in 1978. Like many similar organizations, the AOA Sports Vision Section afforded practitioners a venue for continuing education, for obtaining updates through an e-newsletter, for a referral network through a member directory, and for gaining access to professional materials such as the Sports Vision Guidebooks and the Sports Vision Bibliography. The Section was also active in interprofessional relations with other organizations, such as the U.S. Olympic Committee, Special Olympics, Amateur Athletic Union (AAU) Junior Olympics, American College of Sports Medicine, National Athletic Trainers' Association, and National Collegiate Athletic Association. The Section provided practitioners and students opportunities to participate in sports vision activities, such as the sports vision screening program at the annual AAU Junior Olympic Games. In 2016, the Sports Vision Section was converted to the Sports and Performance Vision committee (www.aoa.org/optometrists/tools-and-resources/sports-and-performance-vision) and continues with many of the same goals and i...