TESTING AND IMPROVING TESTING AND IMPROVING SPORTS VISION SPORTS - PowerPoint PPT Presentation

Sports Vision Evaluation Sports Vision Evaluation Eye Teaming & Spatial Eye Teaming & Spatial Localization Localization – Lateral Disparity vs. Random Dot Lateral Disparity vs. Random Dot – AO Vectographic Vectographic Slide Slide AO Mentor BVAT Mentor BVAT Random Dot Random Dot

Sports Vision Evaluation Sports Vision Evaluation Eye Teaming & Spatial Localization Eye Teaming & Spatial Localization – Speed of Stereopsis Speed of Stereopsis – Timed Random Dot Timed Random Dot Mentor BVAT Mentor BVAT

Sports Vision Evaluation Sports Vision Evaluation Eye Teaming & Spatial Localization Eye Teaming & Spatial Localization – Howard Dolman Apparatus Howard Dolman Apparatus –

Literature Support Literature Support Studies have demonstrated that binocular Studies have demonstrated that binocular vision can improve performance on vision can improve performance on certain tasks compared to one- -eyed eyed certain tasks compared to one performance. performance. Research comparing static stereopsis Research comparing static stereopsis performance has had mixed results with performance has had mixed results with athletes, some differences due to athletes, some differences due to differences in testing procedures used. differences in testing procedures used.

Dynamic Stereoacuity Stereoacuity Dynamic It has been suggested that the lack of It has been suggested that the lack of correlation between depth perception and correlation between depth perception and athletic performance is due to the static athletic performance is due to the static nature of the testing. nature of the testing. Dynamic stereopsis assessment Dynamic stereopsis assessment procedures have been suggested to procedures have been suggested to discriminate differential performance discriminate differential performance relating to sports. relating to sports.

Sports Vision Sports Vision Evaluation Evaluation Vergence Function Vergence Function – Vergence Ranges Vergence Ranges – – Vergence Facility Vergence Facility – Accommodative Function Accommodative Function – Near Near- -Far Facility (Haynes) Far Facility (Haynes) –

Literature Support - - Literature Support Vergence Ranges Vergence Ranges Only 2 published studies have compared Only 2 published studies have compared vergence ranges in athletes to vergence ranges in athletes to nonathletes. nonathletes. One study found no statistical difference One study found no statistical difference in performance, and one found narrower in performance, and one found narrower ranges in athletes (speculated to ranges in athletes (speculated to correspond to more accurate spatial correspond to more accurate spatial judgments via EOM action). judgments via EOM action).

Literature Support - - Literature Support Near point of Convergence Near point of Convergence There have been mixed results on studies There have been mixed results on studies of NPC ability and sports performance. of NPC ability and sports performance. It is theorized that the more dynamic It is theorized that the more dynamic nature of the testing assess vergence nature of the testing assess vergence function more “ “globally globally” ” than static than static function more procedures. procedures.

Literature Support - - Literature Support Vergence Facility Vergence Facility There have been mixed results on There have been mixed results on studies of vergence facility using studies of vergence facility using prisms and sports performance. prisms and sports performance. It has been suggested that a near- -far far It has been suggested that a near method of assessment more closely method of assessment more closely simulates “ “real world real world” ” accommodative accommodative- - simulates vergence facility demands. vergence facility demands.

Literature Support - - Literature Support Accommodative Facility Accommodative Facility Studies using lenses to assess Studies using lenses to assess accommodative facility in athletes found accommodative facility in athletes found no difference in performance compared to no difference in performance compared to nonathletes. nonathletes. Similar to vergence facility, it has been Similar to vergence facility, it has been suggested that a near- -far method of far method of suggested that a near assessment more closely simulates “ “real real assessment more closely simulates world” ” accommodative accommodative- -vergence facility vergence facility world demands. demands.

Sports Vision Evaluation Sports Vision Evaluation Oculomotor Function Oculomotor Function – Subjective Qualitative Assessment Subjective Qualitative Assessment – – Projected tests (DEM, King Projected tests (DEM, King- -Devick) Devick) – – Objective Eye Movement Recording Objective Eye Movement Recording – (Ober Ober Visagraph Visagraph) ) (

Literature Support - - Literature Support Shorter Latencies/Trainable? Shorter Latencies/Trainable? Studies have found that athletes do NOT Studies have found that athletes do NOT have shorter latencies for initiating pursuit have shorter latencies for initiating pursuit or saccadic eye movements. or saccadic eye movements. However, if the target trajectory is However, if the target trajectory is predictable, the latency period be reduced predictable, the latency period be reduced through a learning effect (e.g., initiating through a learning effect (e.g., initiating the correct pursuit eye movement to track the correct pursuit eye movement to track a baseball pitch). a baseball pitch).

Sports Vision Evaluation Sports Vision Evaluation Speed of Recognition Speed of Recognition – Tachistoscope Tachistoscope Presentation Presentation – Limitation of Eye Movements Limitation of Eye Movements

Literature Support Literature Support There have been mixed results when There have been mixed results when comparing speed and span of recognition comparing speed and span of recognition in athletes to nonathletes (speed is usually in athletes to nonathletes (speed is usually better than span). better than span). The use of number sequences for recall The use of number sequences for recall may be the confounding factor, and this may be the confounding factor, and this may be overcome by the use of more may be overcome by the use of more ergonomically appropriate targets (sport- - ergonomically appropriate targets (sport specific). specific).

Inspection Time Inspection Time It is the psychophysical measurement of It is the psychophysical measurement of visual processing time, with shorter visual processing time, with shorter inspection times allowing accurate inspection times allowing accurate decision to be made from shorter stimulus decision to be made from shorter stimulus durations. durations. Most studies have found that experienced Most studies have found that experienced athletes can evaluate relevant visual athletes can evaluate relevant visual information more rapidly than information more rapidly than inexperienced observers. inexperienced observers.

VISUAL SKILLS TO EVALUATE VISUAL SKILLS TO EVALUATE Motor Response Time Motor Response Time Visual- -Motor Reaction Motor Reaction Visual Time Time

Literature Support – – Literature Support Motor Response Time Motor Response Time Simple motor response times have Simple motor response times have been demonstrated to be faster in been demonstrated to be faster in athletes than nonathletes. athletes than nonathletes.

Literature Support - - Literature Support Visual Motor Reaction Time Visual Motor Reaction Time Simple visual- -motor reaction time motor reaction time Simple visual studies have had mixed results. studies have had mixed results. – Several studies found faster Several studies found faster RT RT’ ’s s in in – athletes in various sports, and it was a athletes in various sports, and it was a good discriminator of expertise level. good discriminator of expertise level. – Other studies have not found this Other studies have not found this – correlation. correlation.

Sports Vision Evaluation Sports Vision Evaluation Eye Foot Speed Eye Foot Speed

Literature Support Literature Support Simple eye- -foot visual foot visual- -motor reaction motor reaction Simple eye time studies have found faster RT RT’ ’s s in in time studies have found faster athletes in various sports, and it was a athletes in various sports, and it was a good discriminator of expertise level. good discriminator of expertise level.

VISUAL SKILLS TO VISUAL SKILLS TO EVALUATE EVALUATE Eye- -Hand Hand Eye Coordination Coordination

Literature Support Literature Support Using different evaluation methods Using different evaluation methods and equipment, the results of eye- - and equipment, the results of eye hand coordination in athletes has been hand coordination in athletes has been demonstrated to be better than demonstrated to be better than nonathletes in most studies. nonathletes in most studies.

Lighting Levels Lighting Levels The level of ambient room lighting The level of ambient room lighting has been shown to effect has been shown to effect performance on the Wayne Saccadic performance on the Wayne Saccadic Fixator and the Acuvision Acuvision. . Fixator and the – Lower ambient illumination improves Lower ambient illumination improves – performance performance

VISUAL SKILLS TO VISUAL SKILLS TO EVALUATE EVALUATE Visual Coincidence- - Visual Coincidence Anticipation Skills Anticipation Skills

Literature Support Literature Support Performance on the Bassin Bassin Performance on the Anticipation Timer did not correlate Anticipation Timer did not correlate with batting performance in baseball or with batting performance in baseball or softball. softball. Timing accuracy was found to improve Timing accuracy was found to improve with increasing target velocity, with increasing target velocity, decreasing range of movement, and decreasing range of movement, and length of the runway. length of the runway.

VISUAL SKILLS TO VISUAL SKILLS TO EVALUATE EVALUATE Peripheral Vision Peripheral Vision – Threshold Visual Field Threshold Visual Field –

Literature Support - - Literature Support Extent of Visual Field Extent of Visual Field Study results indicate that athletes Study results indicate that athletes have a larger extent of horizontal and have a larger extent of horizontal and vertical visual fields than nonathletes. vertical visual fields than nonathletes. However, it was NOT found to be a However, it was NOT found to be a sensitive discriminator of skill level sensitive discriminator of skill level within a sports population (Varsity vs. within a sports population (Varsity vs. JV collegiate football). JV collegiate football).

Literature Support – – Literature Support Form Recognition in Periphery Form Recognition in Periphery Study results indicate that athletes Study results indicate that athletes have better form recognition at more have better form recognition at more peripheral locations than nonathletes. peripheral locations than nonathletes.

Literature Support - - Literature Support Peripheral Awareness/Reaction Peripheral Awareness/Reaction Only normative data have been Only normative data have been published for measurements of published for measurements of peripheral awareness/reaction using peripheral awareness/reaction using the Wayne P.A.T.T. in athletes. the Wayne P.A.T.T. in athletes.

VISUAL SKILLS VISUAL SKILLS TO EVALUATE TO EVALUATE Eye- -Body Coordination Body Coordination Eye Vision & Balance Vision & Balance Field Dependence- - Field Dependence Independence Independence Visualization Visualization

VISUAL SKILLS TO VISUAL SKILLS TO EVALUATE EVALUATE Ocular Health Ocular Health Procedures Procedures

Other considerations for the Rx Other considerations for the Rx Timing of first prescription Timing of first prescription Value of overminusing Value of overminusing Prescribing for twilight Prescribing for twilight Prescribing for specific Prescribing for specific distances distances Prescribing modalities: Prescribing modalities: – Spectacles Spectacles – – Contact lenses Contact lenses – – Refractive surgery Refractive surgery –

Spectacle Considerations Spectacle Considerations ANSI standards and the sport ANSI standards and the sport Wrap designs Wrap designs Contact sports Contact sports Weather and atmospheric Weather and atmospheric conditions conditions Prescribing tints Prescribing tints Considerations for presbyopes presbyopes Considerations for

VISUAL TASK VISUAL TASK

VISUAL TASK VISUAL TASK Filters & Visual Information Processing Filters & Visual Information Processing Driven by information provided from Driven by information provided from visual input (VA, CSF, Stereopsis, etc.) visual input (VA, CSF, Stereopsis, etc.) Specific skills affected by filters: Specific skills affected by filters: – Visual Discrimination Visual Discrimination – – Visual Figure Visual Figure- -Ground Ground –

Filters and Lighting Variations Filters and Lighting Variations Incandescent lighting Incandescent lighting Fluorescent lighting Fluorescent lighting Sodium lighting Sodium lighting Daylight (clear vs. Daylight (clear vs. cloudy) cloudy) Outdoor night lighting Outdoor night lighting

Filters and Performance Factors Filters and Performance Factors

VISUAL SKILLS VISUAL SKILLS THROUGH FILTERS THROUGH FILTERS Visual Acuities Visual Acuities Refractive Status Refractive Status Contrast Contrast Sensitivity Sensitivity Dynamic VA Dynamic VA

VISUAL SKILLS VISUAL SKILLS THROUGH FILTERS THROUGH FILTERS Phorias & & Vergences Vergences Phorias (stance & facility) (stance & facility) Fixation Disparity Fixation Disparity Speed & Accuracy Speed & Accuracy of Depth Perception of Depth Perception

VISUAL SKILLS VISUAL SKILLS THROUGH FILTERS THROUGH FILTERS Visual- -Motor Motor Visual Reaction Time Reaction Time Eye- -Hand Hand Eye Coordination Coordination

VISUAL SKILLS VISUAL SKILLS THROUGH FILTERS THROUGH FILTERS Vision Anticipation Vision Anticipation Skills Skills Speed of Speed of Recognition Recognition

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Polarizing filters Polarizing filters – Suppresses reflected light (horizontal) Suppresses reflected light (horizontal) – – Best with reflected glare (water, road surfaces) Best with reflected glare (water, road surfaces) – – Transmit a maximum of 50% (usually ~40%) Transmit a maximum of 50% (usually ~40%) – – Act as neutral filters for unwanted reflections Act as neutral filters for unwanted reflections – – Sports applications Sports applications – * Fishing, water sports, driving/cycling (wet surfaces) * Fishing, water sports, driving/cycling (wet surfaces) * May remove important details in skiing, golf, etc. * May remove important details in skiing, golf, etc.

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Photochromic filters filters Photochromic – Transmission characteristics actively Transmission characteristics actively – change change – Usual range is 20% to 80% Usual range is 20% to 80% – transmission* transmission* – Usually neutral or brown tint Usually neutral or brown tint – – Sports applications Sports applications – * Changing light levels (e.g., golf, * Changing light levels (e.g., golf, tennis) tennis)

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Neutral grey filters Neutral grey filters – Filters wavelengths equally Filters wavelengths equally – – Keeps colors more Keeps colors more “ “natural natural” ” – – Sports applications Sports applications – * When subtle color differences matter * When subtle color differences matter … … * Golf, mountaineering, skiing * Golf, mountaineering, skiing * Mountaineering: blocks yellow light in * Mountaineering: blocks yellow light in whiteout whiteout

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Neutral grey filters Neutral grey filters – Filters wavelengths equally Filters wavelengths equally – – Keeps colors more Keeps colors more “ “natural natural” ” – – Sports applications Sports applications – * When subtle color differences matter * When subtle color differences matter … … * Golf, mountaineering, skiing * Golf, mountaineering, skiing * Mountaineering: blocks yellow light in * Mountaineering: blocks yellow light in whiteout whiteout

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Red range filters Red range filters – Enhances objects in the red spectrum Enhances objects in the red spectrum – – Sports applications Sports applications – * Orange clay shooting * Orange clay shooting * Skiing (contrast changes of * Skiing (contrast changes of reflected light) reflected light)

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Yellow range filters Yellow range filters – Transmits only longer wavelengths Transmits only longer wavelengths – – Ocular media scatters short wavelength light more Ocular media scatters short wavelength light more - - – improves contrast by eliminating some of this improves contrast by eliminating some of this “internal glare internal glare” ” “ – May enhance contrast differences (contours) May enhance contrast differences (contours) – – Sports applications Sports applications – * Shooting sports, Snow sports, Driving, Flying * Shooting sports, Snow sports, Driving, Flying * Blue backgrounds (tennis, baseball, golf, etc.) * Blue backgrounds (tennis, baseball, golf, etc.)

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Specialty filters - - Mirror Coatings Mirror Coatings Specialty filters – Limits glare and increases Limits glare and increases – absorption absorption – Reduces Infra Reduces Infra- -Red Red - - reducing heat reducing heat – build- -up up build – Sports applications Sports applications – * Snow Sports * Snow Sports * Water Sports * Water Sports * Cycling/Running * Cycling/Running

FILTER TYPES & SPORTS FILTER TYPES & SPORTS Specialty filters - - Anti Anti- -reflective coating reflective coating Specialty filters – Minimizes reflections Minimizes reflections - - especially back especially back – surface surface – Sports applications Sports applications – * Racquet sports * Racquet sports * Fishing * Fishing * Shooters/Archery * Shooters/Archery

LENS DESIGN FACTORS LENS DESIGN FACTORS Goggle designs Goggle designs – Ski goggles Ski goggles – – Swimming Swimming – goggles goggles – Diving masks Diving masks –

Performance Contact Lenses Performance Contact Lenses Factors to consider: Factors to consider: – Gaze positions (ex: Gaze positions (ex: upgaze upgaze for cyclists) for cyclists) – – Speed of eye movements (re Speed of eye movements (re- -orientation) orientation) – – Length of competition Length of competition – – Environment (humidity, temperature, altitude, Environment (humidity, temperature, altitude, – debris, wind, UV exposure) debris, wind, UV exposure) – Replacement possibilities Replacement possibilities – – Tint possibilities Tint possibilities –

CONTACT LENS CONTACT LENS CONSIDERATIONS CONSIDERATIONS Material: water content Material: water content Diameter Diameter Handling Characteristics Handling Characteristics Stability Stability Replacement : ease and Replacement : ease and frequency frequency – spare lenses on sidelines spare lenses on sidelines – – solutions on hand solutions on hand – – 1 1- -day lenses day lenses –

Importance to Wearers- - MAX EYES MAX EYES Importance to Wearers Ocular Health in Ocular Health in Performance Vision: Performance Vision: – Reduce UVA, UVB Reduce UVA, UVB – – Reduce visual Reduce visual – fatigue fatigue – Eliminate potential Eliminate potential – – “ “Device Device” ” hazard hazard – – Minimizes blue Minimizes blue – – Light hazard Light hazard – 100 50 East West 0 North 1st 3rd Qtr Qtr

COMPLIANCE ISSUES COMPLIANCE ISSUES 100% non- -compliant with at least compliant with at least 100% non one step one step 95% either don’ ’t disinfect or clean t disinfect or clean 95% either don regularly regularly 94% don’ ’t keep case clean t keep case clean 94% don 53% fail to wash hands 53% fail to wash hands

EMERGENCY KIT FOR THE EMERGENCY KIT FOR THE ATHLETIC TRAINER ATHLETIC TRAINER Non- -preserved saline preserved saline Non Lubricating drops Lubricating drops Several clean contact lens Several clean contact lens cases cases DMV lens removers DMV lens removers Fluo strips Fluo strips Sterile swabs Sterile swabs Anesthetic? Anesthetic?

Sports Eye Injury Prevention Sports Eye Injury Prevention Educate the general Educate the general public public Proper coaching for safe Proper coaching for safe play play Modify regulations Modify regulations Promote proper eyewear Promote proper eyewear

Sports Eye Injury Prevention Sports Eye Injury Prevention Comprehensive patient care Comprehensive patient care Regular visits Regular visits Thorough case history Thorough case history Legal/ethical responsibility to identify & Legal/ethical responsibility to identify & warn warn Verify habitual sports/recreational Verify habitual sports/recreational eyewear: eyewear: – Appropriate for risk(s) Appropriate for risk(s) – – Meets relevant standards Meets relevant standards – – Inadequate condition Inadequate condition –

Prevalence (all trauma) Prevalence (all trauma) 2.5 million cases per year in U.S. 2.5 million cases per year in U.S. 40,000- -45,000 cases of permanent visual 45,000 cases of permanent visual 40,000 impairment impairment Accounts for 20% of unilateral blindness; Accounts for 20% of unilateral blindness; 7% of bilateral 7% of bilateral 70% male 70% male Sports related ocular trauma=100,000+ per Sports related ocular trauma=100,000+ per year year

Sports Eye Injury Prevention Sports Eye Injury Prevention Pre- -existing conditions that increase risk: existing conditions that increase risk: Pre – Post Post- -refractive surgery refractive surgery – – High myopia High myopia – – Visual field defects Visual field defects – – IOL implants IOL implants – – Other surgical procedures to eye Other surgical procedures to eye – tissues tissues – Amblyopia and Strabismus? Amblyopia and Strabismus? –

Eye Injuries Associated With Eye Injuries Associated With Sports Sports Prevent Blindness America The use of protective eyewear for the face and eyes could effectively reduce the frequency and severity of sports related eye injuries by 90%.

Determination of Risk – – Determination of Risk Classification of Various Sports Classification of Various Sports By Physical By Physical Contact: Contact: – Contact/Collision Contact/Collision – – Limited Contact Limited Contact – – No Contact No Contact –

High Contact/Collision High Contact/Collision Sports Sports Basketball Basketball Hockey (Field and Hockey (Field and Ice) Ice) American Football American Football Soccer Soccer Rugby Rugby Water Polo Water Polo Wrestling Wrestling Boxing Boxing

Limited Contact Limited Contact Baseball Baseball Skiing (Snow & Water) Skiing (Snow & Water) Squash/Racquetball/Hand Squash/Racquetball/Hand ball ball Volleyball Volleyball Windsurfing/Surfing Windsurfing/Surfing Kayaking Kayaking Cycling Cycling Gymnastics Gymnastics

Noncontact Noncontact Archery & Riflery Archery & Riflery Crew/Rowing Crew/Rowing Track & Field Track & Field Golf Golf Running Running Sailing Sailing Swimming & Scuba Diving Swimming & Scuba Diving Tennis, Badminton & Table Tennis, Badminton & Table Tennis Tennis Weight lifting Weight lifting

Sports Eye Injury Sports Eye Injury Demographics Demographics True incidence is unknown True incidence is unknown No reliable, fast & complete data No reliable, fast & complete data collection systems in place collection systems in place Must rely on incomplete data from Must rely on incomplete data from various data gathering systems various data gathering systems Data does show a major public health Data does show a major public health problem problem