Looking Deeper Into the Visual System
The visual system piqued my interest a few years ago while I was sitting through a presentation from Dr. Josh Bloom, a local concussion expert, at Pete Friesen's Physio-Fitness Summit in Raleigh, NC. To paraphrase, Dr. Bloom mentioned that visual problems secondary to a concussion are associated with neglecting vision in one eye, which can lead to feeling dizzy or “off”; forcing the athlete to use the neglected eye can cause symptoms to clear up within a couple days. My interest was furthered by a conversation I had with Dr. Barry Tannen, where he mentioned that post-concussion, some athletes that have had an astigmatism, but with no symptoms, will start to show textbook symptoms of the astigmatism; treating the astigmatism relieves the ongoing symptoms. The reality is that our visual system is a MAJOR source of sensory input about the environment around us, and, for most athletes, it really doesn't receive the attention it deserves.
Concussions aside, when most players have their eyes checked, the screen basically consists of:
1. Is there an objecting sticking into your eye?
2. Do you have 20/20 vision?
While it's mildly more complicated than this, it's only mildly more complicated than this. As for 20/20 vision, are you familiar with where this number comes from? In an article published at VisionHelp.com titled “The Amazing Truth of 20/20 Eyesight”, Dr. Barry Tannen writes:
In 1862, a man named Snellen devised a testing system to determine people's eyesight. He asked people to stand at 20 feet and through experimentation discovered the smallest sized letter that most people with good eyesight could see. He called this a size 20 letter and the vision was recorded as 20/20. At the time it was thought that this was all you needed in the way of vision. Actually it was a great breakthrough at the time. Now, over 130 years later, we have made quantum leaps in our knowledge of the human visual system. Yet, if you walk into many schools and pediatrician's offices and even some eye doctor's offices the old 20/20 standard is still the only way that vision is tested.
Recently, I've had the pleasure of reading See to Play: The Eyes of Elite Athletes by Dr. Michael Peters, an optometrist who works closely with the Carolina Hurricanes. In See to Play, Dr. Peters mentions that the best athletes he's worked with typically have the best visual systems, and many have a visual acuity of 20/8. Dr. Peters highlights this finding by sharing a story whereby he showed he took the Hurricanes players through a battery of tests and then showed Pete Friesen how the players ranked according to the quality of their visual system, which Pete responded to by joking that he might as well have just ranked them by their salary.
This story highlights a few important concepts:
1. There is a distinct difference between what is normal (minimum acceptable competency) and what is optimal (maximum capacity). This is true of the visual system, and just about all other health markers.
2. For elite level athletes (or athletes that aspire to be elite), an assessment of the visual system should go deeper than simply whether the athlete has 20/20 vision or not.
3. Related to the point above, because the visual system is heavily neural-based, limitations in any of the qualities found through a more comprehensive examination are trainable and can have a profound impact on an athlete's performance.
Dr. Peters identified 7 key areas of vision that warrant assessing:
1. Visual Acuity
2. Detailed Vision Range
3. Extreme Side Vision
4. Eye Alignment of Aiming
5. Eye Alignment on Object
6. Eye Focusing
7. Eye-Hang Coordination
This battery will help identify individual limitations that could have a significant impact on the athlete's performance (athletic and academic). It also provides direction from a training perspective, as Dr. Peters goes on to detail training exercises to improve each component with minimal equipment. In recognizing the value of this information, the first question that arose was, “Where can I find someone to assess our athletes locally?” Fortunately, there is a resource that serves this purpose well: http://bettervision.com/behavioraloptometrists.html
While each professional likely has their own twist on things, behavioral optometrists, in general, seem to be more likely to dig deeper into the various components of the visual system. Naturally, See to Play by Dr. Peters would also be a great resource, as it has user friendly assessments and training progressions for each of the aforementioned qualities.
Wrap-Up
As with all of the body's systems, our collective understanding of the visual system has progressed over the years. Unfortunately, the baseline assessment most athletes go through, has not. It's likely that many athletes are limiting their potential by not pursuing a more thorough assessment of their visual system, and proactively training to improve. Hopefully, through resources like the website provided above and Dr. Peters' See to Play, more athletes, parents, and coaches will begin to recognize the benefits of visual training.
