CLINICAL

  SPORTS VISION

SNOW VISION

ADDRESS THE VISUAL NEEDS OF YOUR PATIENTS ON THE SLOPES

GRAHAM B. ERICKSON, O.D., F.A.A.O., F.C.O.V.D.

GLARE AND poor contrast are among the common vision challenges encountered by snow sport participants. Appropriate vision care can address both. Eyewear also is necessary for snow sports. Increased UV radiation at higher levels, and reflection of 85% of UV rays off the snow, present an additional risk of photokeratitis when appropriate UV filters are not used. Protection from ocular trauma, such as impact from a ski pole, and performance advantages are additional benefits of goggles.

Here, I discuss the visual performance factors and eyewear to help these patients conquer the snow.

VISUAL PERFORMANCE

In snow sports, static and dynamic VA, contrast sensitivity and distance stereopsis are critical for providing optimal visual information for decision making. These basic visual performance factors can be optimized by the combination of excellent refractive compensation and appropriate filters. For visual performance training, I recommend using strobe eyewear during balance training to maximize benefits. For eye-body speed, I suggest the Electronic Balance Board (Wayne Engineering), FitLight Trainer or the The Quick Board instruments.

GOGGLES

Snow sport participants may choose to either wear goggles with prescription inserts or wear plano goggles over their contact lenses. The latter is typically preferred, as field-of-view aberrations, VF restriction and optical distortion can occur with lens inserts. Any goggles should provide UV protection, and also meet international safety standards. (For specifics, visit tinyurl.com/ASTMF659.) Other issues:

• Contact lenses. To maximize oxygen transmission at high altitudes, for example, while skiing, a high water-content hydrogel lens (e.g., 70% water content) or silicone hydrogel lenses should be used, even though high water-content lenses can dehydrate faster in the cold, dry climate at high altitude. Silicone hydrogel lenses are preferable, as they have been shown to provide increased comfort for patients who have dry eye disease and to help with the dry winter weather conditions.

Daily disposable lenses suit the needs of many athletes. Weekend athletes, those who enjoy the comfort of a daily disposable lens and those who prefer fresh lenses before a competition are particularly good candidates for this modality.

• Lens inserts. Even for contact lens wearers, it is helpful to have a back-up prescription insert, just in case there are problems with the contact lenses when skiing or snowboarding.

• Filter use. In low contrast, flat light conditions, a yellow-range or red-range tint is often preferred. The reasons: These filters can brighten and sharpen details while enhancing subtle contrast features. In bright conditions, filters that have lower visible light transmission properties, with neutral gray providing the most natural color appearance, are needed.

SEEK PATIENTS

Identify the patients in your practice who enjoy winter sports, and offer services to help them to see better on the snow. They will appreciate the benefits from improved visual performance, and you’ll establish a sport-friendly reputation for your practice. OM

DR. ERICKSON is a professor at Pacific University College of Optometry. He is a past chairman of the AOA Sports Vision Section and an AAO diplomate. He is author of “Sports Vision” and lectures on this topic, pediatrics and binocular vision. He is a consultant to Sepatec and ZEAVision.