Sports Vision G. Janssen

Sports Vision:
What is the connection between sports and vision?
Gabrille Janssen, optometrist

Gabrille Janssen, optometrist
Fellow of the American Association of Optometry
Bachelor Business Administration
Sports Vision (AJAX)
Contact lenses
Pre- en postoperative management of cornea transplants
Lecturer optometry
Medical Advisor NGO Eye Care Foundation
Board Member of the Dutch Optometry Association

Sports performance
Biomechanical factors
Strength
Condition
Visual factors
Cognitive factors
Etc. Etc.
Sports performance
Biomechanical factors
Strength
Condition
Visual factors
Cognitive factors
Etc. Etc.
The ocular and visual characteristics of an athletic
population
Beckerman SA and Hitzeman S. Optometry 2001; 72:8 498-509
1. 25% of athletes competing at a high level had never a complete eye examination
2. 29% had visual symptoms
3. 28% had less than 20/25 or 0,8 visual acuity
4. Protection eye wear was not often used

Screening ADO Den Haag 2010
Visual Acuity
Binocular vision
Color Vision
Dominance
Contrast Sensitivity
Eye-Hand coordination
Eye-Feet coordination
Accommodation-vergence
Wat is Sports Vision?
1. Detection of visual problems
2. Optimizing visual acuity
3. Improvement of visual skills
4. Protection and Prevention

Information Processing Model
Perceptual Mechanism
A. Visual resolution (VA, CSF, DVA)
B. Depth perception (Stereopsis, Vergence)
C. Eye movements (Saccades, Visual persuits)
D. Peripheral vision
1. Detection of visual
imperfections
Sport Importance + Importance -
Hockey Visual Acuity

Dynamic visual acuity
Visual persuits
Eye-hand coordination
Depth perception
Reaction time
Peripheral vision
Running Peripheral visual acuity Visual Acuity

Dynamic visual acuity
Visual persuits
Eye-hand coordination
Depth perception
Reaction time
Peripheral vision
Golf Visual Acuity

Visual persuits
Reaction time
Peripheral vision
Eye-hand coordination Dynamic visual acuity
Depth perception
Human Movement Sciences VUmc
Savelsbergh, v.d. Kamp, 2002
Alignment of the preferred leg

Profesional: less eye movements
Professional: head and legs
Non-Professional: arms, chest and legs
Professional starts later

2. Optimizing visual acuity
1. Glasses
2. Contactlenses: soft or RGP, orthokeratology
3. Refractive Surgery: Lasek, Lasik or implant lenses

Glasses
+ -
Stable vision Fog up
Can give some protection Splattered by rain or perspiration
Limited peripheral vision
Can cause extra trauma

Soft contactlenses
+ -
Peripheral vision May dry out
No fog up Not always stable vision
Comfortable Risk of dislocation
Day lenses are prefered to Not always full correction

reduce the risk of complications
RGP
+ -
Peripheral vision May dry out
No fog up High risk for corpus alienum
Low risk of complications May get lost
Not always stable vision
Risk of dislocation
Not very comfortable

Orthokeratology
<-4 dpt
+ -
Peripheral vision It takes some weeks to obtain
good visual acuity
Reversible
Risk of glare and halos
Feels like no ametropia
Limited correction
Stable vision during the day
Risk of complications because of
night wear
Incidence non-severe and severe Microbial
Keratitis per 10.000 contactlens wearers a year
Non-severe keratitis Severe keratitis
DW RGP 5.7 2.9
DW hydrogel 9.1 6.4
DW Silicone hydrogel 55.9 0.0
EW hydrogel 48.2 96.4
EW silicone hydrogel 98.8 19.4
Morgan PB, Efron N, Incidence of keratitis of varying severity among contact lens wearers, 2005
Lasek
+2 dpt - -6 dpt
+ -
Peripheral vision Reduced contrast sensitivity
Greater confidence in vision Risk of glare and halos
Less worry about eye problems Irreversible

and fluctuating vision
No concerns about glasses or

contact lenses
Feels like ametropia
Less risk of complications than

Lasik, implantlenses, etc
LASIK
+3 dpt - -8 dpt
+ -
Peripheral vision Reduced contrast sensitivity
Greater confidence in vision Risk of glare and halos
No concerns about glasses or Dry eyes

contact lenses
Irreversible
Risk of complications: flap
dislocation
Phakic Implantlens
+10 dpt - -20 dpt
+ -
Peripheral vision Risk of complication
Greater confidence in vision After Phakic implantlens hockey

with eye protection advisable
No concerns about glasses or
contact lenses
No reduction of contrast
sensitivity
3. Improvement of visual skills
Improvement?
Some visual skills can be improved
Visual skills improvement performance absolute

identification
Need of more evidence based research

4. Protection and prevention
Epidemiology
American Academy of Ophthalmology

Eye Health and Public Information Task Force
Ophthalmology 2004
Aye for an eye?
Gary Brown, ncca.org
25% of the injuries are to the head or face
Eyelid laceration
Corneal abrasion
Orbital fractures
Conjunctiva
Other
Open & Closed bulbus
Prevention
A. Polycarbonate ASTM F803
B. Mineral
C. Allyl Resin Plastic
D. High-Index Plastic
Summary
High number of athletes never had an eye examination
In hockey: visual acuity, visual persuits, eye-hand
coordination, depth perception, reaction time and
peripheral vision are important
Preferred correction: soft contactlenses, orthokeratology
or Lasek
Playing hockey causes a high risk for ocular trauma

Conclusion
Eye examination can improve sport results
Superior visual skills are of little consequence
compared with the congnitive processing of the
visual information
No evidence based results for enhancement of
visual skills in sports (behavioral optometry)

Recommendation

Sports Vision G. Janssen

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Sports Vision:

What is the connection between sports and vision?

Gabrille Janssen, optometrist

Fellow of the American Association of Optometry

Bachelor Business Administration

Sports Vision (AJAX)

Pre- en postoperative management of cornea transplants

Medical Advisor NGO Eye Care Foundation

Board Member of the Dutch Optometry Association

2. 29% had visual symptoms

3. 28% had less than 20/25 or 0,8 visual acuity

4. Protection eye wear was not often used

1. Detection of visual problems

2. Optimizing visual acuity

3. Improvement of visual skills

4. Protection and Prevention

A. Visual resolution (VA, CSF, DVA)

B. Depth perception (Stereopsis, Vergence)

C. Eye movements (Saccades, Visual persuits)

Hockey Visual Acuity

Running Peripheral visual acuity Visual Acuity

Golf Visual Acuity

Alignment of the preferred leg

Professional starts later

2. Contactlenses: soft or RGP, orthokeratology

3. Refractive Surgery: Lasek, Lasik or implant lenses

Can give some protection Splattered by rain or perspiration

Limited peripheral vision

Can cause extra trauma

No fog up Not always stable vision

Comfortable Risk of dislocation

Day lenses are prefered to Not always full correction

No fog up High risk for corpus alienum

Low risk of complications May get lost

Not always stable vision

Not very comfortable

Non-severe keratitis Severe keratitis

DW RGP 5.7 2.9

DW hydrogel 9.1 6.4

DW Silicone hydrogel 55.9 0.0

EW hydrogel 48.2 96.4

EW silicone hydrogel 98.8 19.4

Greater confidence in vision Risk of glare and halos

Less worry about eye problems Irreversible

No concerns about glasses or

Feels like ametropia

Less risk of complications than

Greater confidence in vision Risk of glare and halos

No concerns about glasses or Dry eyes

Greater confidence in vision After Phakic implantlens hockey

Feels like ametropia

Some visual skills can be improved

Visual skills improvement performance absolute

Need of more evidence based research

American Academy of Ophthalmology

A. Polycarbonate ASTM F803

C. Allyl Resin Plastic

In hockey: visual acuity, visual persuits, eye-hand

coordination, depth perception, reaction time and