Treatment of vision defects in athletes

Ophthalmic examinations play a very important role in sports and medical certification. Among other things, it is our eyesight that determines that we achieve the results we or our coaches intend, without exposing our eyes to excessive strain that can lead to visual disturbances or even loss of vision. When we decide to practice a particular sport in a more organized way, we always undergo qualifying (and later periodic) examinations.

The transition from amateur to professional sports involves not only the need to diagnose possible eye defects, but also eye diseases. From a practical point of view, a fundamental distinction needs to be made between physical activity for recreational purposes and the physical exertion associated with competitive sports.

“The biggest problem in qualifying for qualified (competitive) sports is the lack of statutory regulations on the required standards on the part of the eye. In most studies one can find only guidelines and recommendations, which have no binding force and which, in addition, are subject to constant changes and updates. If the peculiarities of individual sports are taken into account, the same ophthalmological requirements from all professional athletes seem unauthorized.” [source].

Sports doctors are of the opinion that in most sports a visual acuity of 0.5 in one eye and 0.8 in the other is sufficient, because in such a range the capabilities of binocular vision, important formotor activity, are preserved. But there are some disciplines in which falcon vision is really necessary. These include shooting, archery, or even ski jumping.

Prof. Dr. med. Krzysztof Klukowski of the Institute of Optoelectronics at the Military University of Technology in Warsaw cites the example of […] health problems with the eyes of junior world vice-champion Klemens Murańko, which were reported in the media, information reached the public, perhaps for the first time, about corneal cone . It further reads:

“This progressive and asymmetrical corneal dystrophy causes blurring of the image shape and deterioration of visual acuity for both distance and near vision, noticeable especially in inadequate lighting. This is the reason why Klemens Murańka had a dangerous fall at the hill in Stams, Austria, in 2012 during training. The athlete had been hiding his health indisposition for a long time. In this case, the athlete’s determination, his will to fight and his desire to pursue his dreams prevailed over common sense. In an interview, the jumper said: “I didn’t see the coach waving the flag,” “When I looked at the mountains, all the peaks merged into one. And the forests were just a big blur, how could I function like that? Regarding ski jumping, it is worth recalling that in a very short period of time (5-8 seconds) when flying at 90-100 km/h, the jumper feels the air resistance (the sensation of going up) and the position of his body in space, as well as the speed at which he is approaching the landing. He does not always perceive the lines measuring the distance. Therefore, his visual organ should work reliably.” [source].

Who is not recommended to engage in competitive sports? Individuals who have been diagnosed with:

• Myopia greater than -4 diopters
• Hyperopia greater than +4 diopters
• Astigmatism from +2 Dcyl or -2 Dcyl
• Glaucoma with visual field defects
• Degeneration of the retinal periphery predisposing to retinal detachment
• Chronic diseases of the eyelid margins, conjunctiva not amenable to treatment (water sports, inability is in force until the symptoms disappear),
• lack of an eyeball, blindness in one eye, or significant visual impairment with a visual acuity of 0.1.
• history of intraocular surgery

For an athlete, high myopia means not only the discomfort of blurred distance vision, but also the risk of retinal detachment or degenerative and atrophic changes. People with high myopia should avoid excessive physical exertion combined with fluctuations in intraocular pressure or optokinetic nystagmus (occurs when viewing fast-moving objects)

People with high myopia and diagnosed degenerative changes of the fundus should avoid sports in which head injuries are common, such as boxing, soccer, jumping into water. They are advised to engage in moderate dynamic exercise – walking, cycling, swimming – which improves microcirculation within the visual organ and inhibits the growth of retinal degenerative changes.

It is important that people who participate in amateur or competitive sports do not have color vision disorders. There are three basic types of color vision disorders:

• monochromatism – total color blindness
• Dichromatism – comes in three variants (red, green or blue color vision disorder)
• abnormal trichromatism – a reduction in the perception of the saturation of one of the colors (red, green or blue).

Each of the above-mentioned cases poses a danger to the sports person, as it makes it impossible to read graphic or luminous symbols, any kind of signage in the field, etc.

Athletes of certain sports should additionally protect their eyes with masks and goggles (paintball, skiing, speedway, mountain biking, etc.).

As Monika Czaińska and Jagna Sobierajewicz note[source]:

Many aspects of the vision process play a huge role in sports, such as visual acuity (including visual acuity of objects in motion), binocular vision, contrast sensitivity, stereoscopic vision, peripheral vision, etc. Of course, depending on the sport, some visual parameters will be more important than others. For example: the quality of stereoscopic vision will be important in all ball sports (such as tennis, basketball, volleyball, squash or billiards), contrast sensitivity in skiing, peripheral vision in sailing or soccer, eye-hand coordination in tennis, climbing, boxing or field hockey. Studies show that correction of even a non-small visual defect can affect sports performance and achievement. In the case of professional athletes, sometimes these small nuances can even decide the winner.

Therefore, can an athlete undergo laser correction of vision defects, or does he have only corrective glasses and contact lenses at his disposal? Of course he can, and even should, because the best possible solution. Contact lenses, although considered a very comfortable solution, also cause problems.

Triathletes, runners, tennis players (especially on brick courts), weightlifters or gymnasts using magnesia, crossfit and outdoor athletes, in a word, athletes in dusty environments should not use contact lenses. Swimmers, on the other hand, should be particularly strict about proper hygiene of their hands, the case and the contact lenses themselves.

It is best to use disposable lenses, thus minimizing the risk of mainly battery and fungal infections, which can cause the development of eye diseases.