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Welcome to question of the day #134

I’ve started to do some sports vision work in my practice. I’ve limited my management to those that involve traditional optometric treatment. I’d like to move on to more advanced treatments now. What can I do?

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 previous Questions 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

As I see it, there are two levels of treatment in sports vision. The treatment that is within the realm of standard optometric practice and treatment that involves the purchase of equipment-which is often expensive-and requires some practice in operation and understanding the results it produces. Here, I will concentrate on treatment involving more sophisticated equipment.

Dynamic visual acuity measures the ability to see clearly when there is relative movement between the player and the object viewed, such as when either or both are in motion. Good dynamic visual acuity is dependent partly upon good static acuity and partly upon the ability to efficiently and effortlessly synchronise the eye and head movement necessary to keep the image of a moving target stable on the macula area of the retina during body movement. See images for measurement and training of dynamic visual acuity.

Time release visual acuity is another way of measuring visual acuity and training reaction time. A computer screen can be used to present letters and numbers for short periods of time. The patient needs to identify as the speed of presentation is increased. See figure.

Many sports people require highly developed peripheral awareness skills and tests may evaluate the speed and accuracy of processing information in peripheral visual space, using tasks that require an action of some sort, such as hitting a button or moving a joystick, in response to peripheral recognition of a visual target in a variety of different visual field locations. This measures and improves eye hand coordination and reaction time. See figures.

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 through the aggregaton of marginal gains.