Welcome to question of the day #132

Welcome to question of the day #132

Does an eye examination for sports vision differ from a regular eye examination?

Remember, sports vision can be described as the science of helping athletes reach peak levels of performance through the enhancement of visual skills.

I outlined in a previous Question of the Day that the following tests are useful when assessing sports vision:

Monocular and binocular vision/visual measurement using a logMAR distance chart

Monocular contrast sensitivity measurement

Ocular tracking

Ocular alignment

Dynamic accommodation

Dominant eye assessment

Colour vision assessment

Stereoacuity

Monocular and binocular vision/visual measurement using a logMAR distance chart-while vision and visual acuity measurement is a standard part of an eye examination for sports vision values need to be obtained using a logMAR chart as this allows very accurate measurements. This is even more accurate if visual rehabilitation is offered to patients.

Monocular contrast sensitivity measurement-this is usually not part of an eye examination but should be part of a sports vision examination. Some sports people with good visual acuity may be under performing in their soprt because they have low contrast sensitivity. The Pelli-Robson chart is an accepted chart for determining contrast sensitivity.

Ocular tracking-this forms part of the those eye examinations where a presenting symptom suggests and eye movement issue. It should be tested for routinely in a sports vision examination. Problems following a moving object can cuase under performance in sports.

Ocular alignment-this forms part of most eye examinations. It should be conducted in all sports vision examinations as fragile ocular alignment can affect visual acuity and visual and cranial comfort. The standard cover test will help in this regard.

Dynamic accommodation-the ability to change focus effeciently when looking from distance to near and back again is important in may sports. It can be measured using flipper lenses. See figure.

Dominant eye assessment-some people have a dominant eye but use the non-dominant eye for sporting activities when only one eye is used, for example archery. Using the dominant eye can help in performance for some sports. Here is a simple way of helping patients work out which is their dominant eye:

Ask the patient to extend their arms out in front of them and create a triangular opening between there thumbs and forefingers by placing there hands together at a 45-degree angle. See figure.

With both eyes open, centre this triangular opening on a distant object — such as a wall clock or door knob.

Close the left eye.

If the object stays centered, the right eye (the one that's open) is the dominant eye. If the object is no longer framed by the hands, the left eye is the dominant eye.

Colour vision assessment-this forms part of some eye examinations. the Ishihara test is adequate for this. Colour vision deficiency cannot be treated but colours can be considered and changed to help impove sport performance.

Stereoacuity-this forms part of some eye examinations. It should be conducted in all sports vision examinations as good depth perception is a requirement for optimal performance in many sports. The TNO test or a test with Wirt Circles will help in this regard.

Being able to provide even a 1% improvement in all these categories of these elements of visual function is very likely to lead to an improvement in sports performance.