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New technology helps eye care practitioners assist their athlete patients
Mens sana in corpore sano, or a “sound mind in a sound body,” is a motto applicable to education and society that dates to the ancient Greeks and Romans.1 The postponed 2020 Olympics in Tokyo with reduced spectators because of the COVID-19 pandemic is a powerful reminder of the importance of sports to the wellness of communities. Sports vision is an opportunity for optometrists to provide important services to future patients.
Contact sports such as lacrosse, baseball, and football illustrate the importance of protective eyewear, which also provides protection against concussion.2 Sports vision training can improve visual performance in many sports, including tennis, baseball, and basketball.3
As sports become faster and more physical, parents may question the need for protective headgear, the use of which has been criticized in women’s lacrosse.4 Only football has a higher incidence rate of concussion than women’s lacrosse. Although helmets are not proven to prevent concussion—and some have argued that they create a “gladiator” effect leading to more physical play—cost-benefit analyses make a compelling argument that protective headgear and eyewear will lead to fewer concussions and eye and other injuries.5
Enhancing visual performance
Optometrists have used sports vision to improve athletic performance for decades, citing that up to 80% of perceptual input necessary for good sports performance is visual.6 Many new technological instruments are available for enhancing an athlete’s visual performance. Professional sports players have even become involved in the development of these technologies. Tampa Bay Buccaneers quarterback Tom Brady partnered with BrainHQ.com in 2016 on a cognitive training module that works on reaction time, useful fi eld of view, visual processing speed, and multiple object tracking.7 Golden State Warriors basketballer Stephen Curry studied Michael Jordan’s ability to shoot free throws under the pressure of the lights at Chicago’s United Center using stroboscopic glasses to boost his shortterm memory and perceptual ability in an initiative commissioned by Nike at Duke University to enhance his jump shots.8-10 Kawhi Leonard also studied these vision training techniques during his run to the NBA championship with the Toronto Raptors.11
Citius, altius, fortius, or “faster, higher, stronger,” is an Olympic and life motto for every patient with a workout routine. The concept of the mobile office has evolved to the mobile gym where everything in life is integrated into smartphones, smartwatches, and other devices.
Visual performance as a business
Sports vision has been an attractive and, for some eye care practitioners, a lucrative aspect of vision practice for more than 30 years. Although some aspects of sports vision have not changed, including how practitioners define what is encompassed in the specialty, advancing technology has changed how services are provided to athletes, whether at the elementary school, college, avocational, or professional level.
Many practitioners in sports vision excel at providing contact lenses for their athletic patients. Some eye care providers offer the best advice about spectacle lens design, including the optical, protective, and transmission characteristics of those lenses. Finally, many practitioners, mostly optometrists, provide sports vision therapy to train athletes in the aspects of visual performance that are most useful for a particular sport.
A good resource for practitioners who serve athletes is the sports and performance vision section on the American Optometric Association website.12
Contact lenses and sports vision Don Teig, OD, FFAO, and Gary Heiting, OD, have written about contact lenses and sports vision on AllAboutVision.com. Although the site is geared toward patients, it is an excellent starting point for helping practitioners communicate with athletes who want a visual advantage.13 The one critical omission on this site is no mention of scleral contact lenses, which I find are an excellent option for many athletes.
Spectacle lenses and sports vision
The most important aspect of spectacle lenses in athletics is protection. In 2000, the most recent year for which there was a report available, more than 42,000 eye injuries related to sports were reported. The best lens material for this protection is polycarbonate. The American Academy of Ophthalmology guidelines provide important information on protective eyewear for various sports.14
Appelbaum et al offer an excellent summary of these technologies. Good visual acuity and other optometric findings are important baselines necessary for information processing in competitive sports.15
Perspectives on modern sports vision Optometric practices will benefit from the understanding of how sports, athletics, and exercise benefit our diverse communities and improve health outcomes.
Improving visual performance for the elite athlete is not the only goal. Sports and exercise are integrated into the music playlists, work life, and the consciousness of Generation Z and future patients.
1. Jones R. Mens sana. Br J Gen Pract. 2017;67(663):435. doi:10.3399/ bjgp17X692609
2. Concussions, vision & your eye doctor. American Optometric Association. June 2018. Accessed September 13, 2021. https://www.aoa. org/AOA/Documents/Practice%20Management/Specialties/SPV/AOAConcussion- FactSheet.pdf
3. Sports vision training. Elite Sports Vision & Performance Academy. Accessed September 13, 2021. https://www. elitesportsvisionandperformanceacademy.com/sports
4. Comstock RD, Arakkal AT, Pierpoint LA, Fields SK. Are high school girls’ lacrosse players at increased risk of concussion because they are not allowed to wear the same helmet boys’ lacrosse players are required to wear? Inj Epidemiol. 2020;7(1):18. doi:10.1186/s40621-020-00242-5
5. Acabchuk RL, Johnson BT. Helmets in women’s lacrosse: what the evidence shows. Concussion. 2017;2(2):CNC39. doi:10.2217/cnc-2017- 0005
6. Vision and sports performance. International Sports Vision Association. Accessed September 13, 2021. https://www.sportsvision. pro/athletes/vision-and-sports-performance/
7. Davis S. Tom Brady uses brain exercises designed for people with brain impairments and it blew away the scientists who created them. BrainHQ. January 29, 2019. Accessed September 13, 2021. https://www. brainhq.com/news/tom-brady-uses-brain-exercises-designed-forpeople- with-brain-impairments-and-it-blew-away-the-scientists-whocreated- them/
8. Joyner MI. Curry vision: explaining the science behind Stephen Curry’s top-tier aim. Sports Illustrated. March 17, 2018. Accessed September 13, 2021. https://www.si.com/edge/2016/03/22/stephencurry- golden-state-warriors-sports-science-vision-training
9. Duke Today Staff. Strobe eyewear training improves visual memory. Duke Today. July 23, 2012. Accessed September 13, 2021. https://today. duke.edu/2012/07/appelbaumstrobe
10. Today’s modern athlete and the impact of science and vision training on athletic performance in sports. Binovi Technologies Corp. Accessed September 13, 2021. https://binovi.com/files/IR/Impact_of_science_ and_Vision_Training_on_Athletic_Performance_in_Sports--WEB.pdf
11. Haberstroh T. How do Kawhi Leonard—and Steph Curry—train their brains? strobe lights (yes, really). TrueHoop blog. January 9, 2017. Accessed September 13, 2021. https://www.espn.com/nba/story/_ / id/18002545/kawhi-leonard-strobe-light-training-nba
12. Sports & performance vision (SPV). American Optometric Association. Accessed September 13, 2021. https://www.aoa.org/ practice/specialties/sports-and-performance-vision?sso=y
13. Heiting G, Teig DS. Contact lenses that improve sports performance. All About Vision. Updated September 2021. Accessed September 13, 2021. https://www.allaboutvision.com/sportsvision/sport-contactlenses. htm
14. Protective eyewear for young athletes – 2013. American Academy of Ophthalmology. April 2013. Accessed September 13, 2021. https://www. aao.org/clinical-statement/protective-eyewear-young-athletes
15. Appelbaum LG, Erickson G. Sports vision training: a review of the state-of-the-art in digital training techniques. Intl Review Sport Exercise Psych. 2018;11(1):160-189. doi:10.1080/1750984X.2016.1266376