Vision and batting

	By Joshua Watt, O.D., a member of the AOA’s Sports and Performance Vision Committee.

Pete Rose was noted for his simple hitting philosophy, "See the ball, hit the ball." Vision, in all its complexity, is a key component to accomplishing what is known by many to be one of the hardest skills to accomplish in sports. After all, common viewing challenges in baseball include, but are not limited to, refractive problems, lack of binocularity, amblyopia, eye coordination difficulties, accommodation difficulties and difficulties with the vestibular or balance systems that inform proprioception.

My ­first realization of optometry's role in sports performance was in middle school and focused on refractive error. My doctor of optometry at the time asked me to stand up in the exam lane in my batting stance and checked my visual acuity. He recommended that I open my batting stance due to my visual acuity and ocular dominance. While I would love to say it made a huge change to my batting performance, it made a bigger change to my future as a doctor of optometry. Perhaps it was more than just refractive error?

Looking at the math, it makes sense why refractive error and enhanced acuity would lead to better performance. According to David Epstein's book "The Sports Gene," after evaluating almost 400 baseball players the average visual acuity was about 20/13. The result is that 20/20 acuity is not adequate with high-level baseball players let alone all the other performance criteria linked to vision performance.

As doctors of optometry, we can ensure that visual skills do not hinder the on-­field performance of the athlete in your exam chair. Here are a few tips that I use, which can be easily applied in the exam lane.

Keep it real

Ask about the real-life playing situations. Do they play games only during the day or do they often have night games under the lights? Visual fatigue and nocturnal myopia can have serious impacts on the athlete's visual acuity during night games. Glare from the sun and stadium lights also can negatively impact on-­field performance. Appropriate refractive correction (sunglasses, contact lenses or good-­ fitting, sport-speci­fic glasses) can minimize the impact of glare and improve contrast sensitivity.

'Game-day' prescription

Contact lenses can be an immediate improvement over glasses for some athletes. Additional bene­fits include the ability to correct for slight astigmatism through a toric contact lens or to provide a "game day" prescription that they do not wear all day but that they wear for games and practices. The athlete may not need to be corrected to 20/13 all day, every day, but when it is time to perform, they can.

Worse before getting better

I have seen that at times a slight change to refractive correction can have an initial negative impact on depth perception until they have adapted to the change. After their adaptation, the positive improvement in their depth perception occurs. Don't try something new right before a major game or tournament. Have them trial the corrective lenses or contact lenses a few times at practice before implementing in a game, especially if it is something they have never worn before or it is a signi­ficant change.

Find more information and tips on how to meet the sports and performance vision needs of your patients.

Disclaimer: The information contained in this article represents the opinion of the author and not the AOA. These are not clinical practice guidelines, nor has the evidence been peer reviewed. There are additional aspects to this topic that may not be presented, or considered, based on the specifics of the case.