Evaluate the visual performance of all patients, not just athletes

08 October 2021

2 minutes to read

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Visual acuity is the most commonly measured visual skill, but too often it is the only skill measured.

Joshua Watt

The types of skills that are central to sports vision assessments, including binocular function, eye team and movement, the ability to concentrate and visual processing, are actually essential for visual performance in all areas. of life.

In my practice, for example, we deal with police officers who have suffered head injuries on the job. While our main goal is to get them back to full-time work, we often find that vision therapy not only brings them back to baseline, but can also improve the visual skills they need to perform well on the field. shooting or to make distinctions in a split second. between threats and normal movements. The tasks of these first responders demand superb visual performance.

In other cases, treatment for sports vision can lead to gains in other functional areas. I recently treated a competitive volleyball player who was referred to me by a coach who noticed that she was having trouble anticipating where the ball was going. I diagnosed problems with binocular function and depth perception, and we started a vision therapy program that improved her performance on the volleyball court.

A less talented athlete (or one with a less insightful trainer) might have given up on the sport much sooner, calling themselves “un-athletic” or “uncoordinated,” to the detriment of their social and physical development. Others might overcome deficits, like this young woman, but end up having a concussion or other injury due to a lack of peripheral awareness.

This patient has also benefited off the field. Improved binoculars led to better grades in school, renewed her enjoyment of reading, and reduced the number of headaches she had. It is something that I can personally relate to. My own Convergence Deficiency was not diagnosed until I was 25, although I saw an ophthalmologist every year. I never complained about not being able to read for more than 15 minutes, and no one has 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 solved with vision therapy.

Based on my experience and the results of my patients, I encourage all optometrists to add a few simple questions and quick tests to their comprehensive eye exam.

Ask the questions:

  • Do you have a headache or drowsiness when you try to read?
  • Is there something you have trouble doing in sports, at school or at work?
  • Is your performance (academic and / or athletic) equal or superior to your potential and your effort?


  • eye alignment and binocular control (tests near the point of convergence, distance and near coverage);
  • eye tracking (fluid pursuit and jerks); and
  • accommodation (negative relative accommodation / positive relative accommodation, establishment ± 2.00 D).

These simple steps could have a huge impact on the life and visual performance of your patients.

For more information:

Joshua Watt, OD, FCOVD, is the owner and clinical director of Impact Vision Therapy, a multi-location referral-based vision therapy specialty practice in Colorado. Watt specializes in visual therapy related to learning, neuro-optometric rehabilitation and sports visual training, in which he helps athletes achieve their best. He is currently chair of the American Optometric Association’s Sports Vision and Performance Committee. Watt will be teaching a course on Visual Performance in Action at the NORA 2021 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 stated. This blog is for informational purposes only and does not replace professional medical advice from a physician. NORA does not recommend or endorse any specific test, doctor, product or procedure. To learn more about our website and online content, Click here.

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