BLOG: Evaluate visual performance in all patients, not just athletes
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Visual acuity is the most commonly measured visual skill, but too often it’s the only skill measured.
The types of skills that are at the center of sports vision evaluations, including binocular function, eye teaming and movement, focusing ability and visual processing, are actually critical for visual performance across all walks of life.
In my practice, for example, we treat police officers who have sustained head injuries on the job. While our primary objective is to get them back to full-time duty, we often find that vision therapy not only gets them back to baseline but can improve the visual skills they need to perform well on the gun range or to make split-second distinctions between threats and normal movements. These first responders’ jobs demand superb visual performance.
In other cases, sports vision treatment can lead to gains in other functional areas. I recently treated a competitive high school volleyball player who was referred by a coach who had noticed that she was having trouble anticipating where the ball was going. I diagnosed problems with binocular function and depth perception, and we began a vision therapy program that improved her performance on the volleyball court.
A less talented athlete (or one with a less perceptive coach) might have dropped out of sports much earlier, labeling themselves as “not athletic” or “uncoordinated,” to the detriment of their social and physical development. Others might power through deficits, like this young lady, but end up getting a concussion or other injury because of a lack of peripheral awareness.
This patient also benefited off the court. Improving binocularity led to better grades in school, renewed her enjoyment of reading and reduced the number of headaches she got. This is something I can personally relate to. My own convergence insufficiency went undiagnosed until age 25, even though I saw an eye doctor annually. I never complained that I couldn’t read for more than 15 minutes, and no one ever asked me about it. It wasn’t until I went to optometry school that I realized I had a convergence problem that could be addressed with vision therapy.
Because of my experience and my patients’ outcomes, I encourage all optometrists to add a few simple questions and quick tests to their comprehensive eye exam.
Ask the questions:
- Do you get headaches or get sleepy when you try to read?
- Is there anything you are struggling to do in sports, school or work?
- Is your performance (academic and/or athletic) equal to or above your potential and effort?
Evaluate:
- eye alignment and binocular control (near point of convergence, distance and near cover tests);
- eye tracking (smooth pursuit and saccades); and
- accommodation (negative relative accommodation/positive relative accommodation, ±2.00 D facility).
These simple steps could have a huge impact on your patients’ lives and visual performance.
For more information:
Joshua Watt, OD, FCOVD, is the owner and clinical director of Impact Vision Therapy, a multilocation referral-based vision therapy specialty practice in Colorado. Watt specializes in learning-related vision therapy, neuro-optometric rehabilitation and sports vision training, in which he helps athletes achieve their best. He currently serves as the chair of the American Optometric Association Sports and Performance Vision Committee. Watt will be teaching a course in vision performance in action at the 2021 NORA virtual conference. For more information and to register, visit www.nora2021.com.
Disclaimer: The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of the Neuro-Optometric Rehabilitation Association unless otherwise noted. This blog is for informational purposes only and is not a substitute for the professional medical advice of a physician. NORA does not recommend or endorse any specific tests, physicians, products or procedures. For more on our website and online content, click here.
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