Fitting contact lenses can be such a routine after awhile, it's easy to forget about that little fitting guide the reps give you the first time a lens launches.  We all know how to do it any way, right?  Pick the right lens, the right add, and over refract.  But with the new launch of Ciba's Dailies Aqua Comfort Plus Multifocal which is utilizing the exact same multifocal design as their original monthly Air Optix Multifocal lens, let's take another look at the fitting guide because what's inside may surprise you.

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How good is good enough?  This is a question that many athletes find themselves wondering when it comes to eyesight.  Today's optometrists and ophthalmologists are investigating the challenges and demands of sports vision -- what advantages does perfect eyesight give to the world's best athletes, and how much of eyesight or visual performance is trainable?  With a ton of new research being produced, we may be able to maximize athlete's innate ocular abilities to give them the best chance to succeed in their field.

Correcting Vision to it's Maximum Potential

Pelli Robson Low Contrast chart--another measurement of vision performance.  Sometimes your eye's ability to detect contrast is poor, but your eyesight with the normal Snellen chart (that 20/20 measurement we all get with routine eye exams) is quite good.  Sports Vision specialists look at all areas of visual peformance, not just letters on one type of chart!  via

We all know that perfect vision is 20/20, but what if you could see better than that?  Many professional athletes see 20/15, 20/10 and even a shocking 20/8 (the best vision ever recorded by a human).  If you naturally are so genetically blessed to have 20/20 vision without needing glasses or contact lenses, but could get help to see 20/10, would it matter  in making you into a professional athlete?  Dr. Mike Peter's excellent book, See to Play discusses the disproportionately better vision that professional sports athletes have to the rest of the population.  So if you want to have your best chance of athletic success, correcting your eyes to their maximum potential may help get you there.

Depending on your sport, contact lenses, tinted sports goggles (especially great in baseball where a tint can help enhance the appearance of a white ball against blue sky or green field), or even LASIK or refractive surgery correction can help your eyes overcome any uncorrected prescription.  Contact lenses have often given athletes issues -- poor comfort, falling out during games.  Today's new generation of daily lenses are so thin that comfort is less of a problem than ever, and lenses like Ciba's Dailies Total 1 are a great option for someone needing high moisture content, but a lens that likes to stay on the eye (sometimes it is even hard for people to remove on purpose).  Maybe with a bit of help you can see that 20/10 or even 20/8 line.  What does that mean to you?  You are seeing a ball, a player, or any other target that much sooner than someone with 'perfect' 20/20 vision standing beside you.  This level of clarity is going to enable you to react faster, because you are seeing things much sooner than anyone else on the field!

Dr. Terry Kim of Duke (I am so lucky to have mutual patients with him in the Raleigh/Durham area!) was the doctor who brought Parker back to perfect vision by convincing him, yes contact lenses can help on and off the court!

A great recent example of how much vision matters on the basketball court is Duke's Jabari Parker.  Parker is nearsighted, but refused to wear his glasses or contact lenses growing up.  When he got to Duke, his vision was an atrocious 20/50 in the right eye, and 20/150 in the left.  In case you are wondering, no that is not legal driving vision.  But he had been successful enough to get recruited by Duke to play basketball with blurry vision, so how much of a difference did wearing his contact lenses make to his game?  Interviews with Duke coaches and staff suggest that Parker is now seeing cues from the sidelines without having to walk over to the bench during the game, able to read his teammates facial expressions for better on court interactions, and of course, able to perform better in the classroom where there has been a significant improvement in the ease with which he is able to study and perform classwork without headaches.  Did I mention he could now legally get a driver's license and operate a motor vehicle again?

But are there some advantages to blurry vision too?

That's an argument that might seem counter intuitive, but blurry may have some unrealized perks.  Take for example Olympic ice skater Jason Brown who ditches his glasses on the ice so that his blurry vision can let him focus on his own skating, instead of the crowd or judges.  A surprising result was also found in a study of basketball players with poor vision performed by optometrist Dr. Raymond Applegate.  He found a slight improvement in free throw percentage in players with 20/20 vision versus 20/40 (but statistically too small to be significant), but really no difference in made free throw success with vision of 20/40 to 20/250.  At a certain point, blurry was blurry and the amount of blur no longer mattered.

Imagine trying to focus on the rim with this circus in the background. Blurring that peripheral mess out is a skill that sports vision optometrists can help train!  via

Why did blurry vision have so little apparent affect on free throw shooting?  Perhaps it harkens to a sports vision training skill known as "the quiet eye".  Imagine shooting a free throw in game -- all those yelling fans, floating heads, balloons, and other shenanigans.  The "quiet eye" technique has players focus on just 1 point of the rim, and purposefully "blur out" the rest of their visual field.  In free throw shots, focus on just the one target is what matters, and the ability to ignore all else is actually helpful. Players with uncorrected vision didn't have to practice this technique; they could only focus on one point clearly anyway!  But if Dr. Applegate's study had had other measurables, wouldn't clear vision have been helpful on spotting that perfect entry pass, or reading someone's eyes for that steal?  Of course.  The best line of action is to make your vision perfect, and then train your eyes to focus on what you need.  That's the beauty of sports vision therapy!  Maximize the eyesight you have, and then train you on how to get your eyes to process the world depending on that particular moment's needs.

In future posts I hope to feature more sports vision topics and how optometrists and eye care specialists are helping future athletes achieve their dreams.  If you are interested in learning more, please head over to Dr. Mike Peter's blog about sports vision, and pick up his book See to Play for a more in depth understanding of how today's science can maximize the vision of tomorrow's sports stars.

While they are battling on the court, did you know these star basketball players are also battling poor eyesight?  Here's a look at college basketball's most prominent stars and their personal ocular challenges.

Rec specs or sports goggles protect the good eye and are made from shatter-resistant material like polycarbonate or Trivex via

Isaiah Austin's right eye prosthetic is almost indistinguishable from his normal left eye.  That's the power of a great prosthetic -- they can be hand painted to perfectly match your other eye!  via

Otule volunteers with visually disabled children often due his own inspirational story of achieving success despite blindness in one eye via

Hard to believe, but it has been since around 2007 since we actually got a new monthly contact lens.  (The Purevision2 lens that launched a few years ago was a recycling of an older material).  In these past seven years, the market has shifted drastically towards daily use lenses, but monthlies continue to dominate the marketplace due to their excellent price points for every day lens wearers.  The big knock against monthlies?  Comfort.  Wouldn't it be nice if they made a monthly lens that felt a lot more like a 2 week or a daily lens?  Well, maybe Bausch and Lomb has finally accomplished just that.

My personal pair of Ultra lenses. Note they dropped "Purevision" from their packaging all together.  B+L is going in a different direction this time

Cosmetic injections and fillers are old news at this point -- we all know that they are commonplace among Hollywood's aging stars, and they have become routine enough in the general population that no one bats an eye at a little Botox or the idea of a lunch-hour cosmetic filler.  But just because dermal injections are increasingly popular (a reported 2.2 million cosmetic injections were performed last year alone in the US!), doesn't mean they are without risk.  A new report published in this month's JAMA (Journal of the America Medical Association) links 3 cases of dermal filler injections with central retinal artery occlusion, an ocular condition that results in permanent vision loss.

Most dermal fillers are tested and approved for use around the nose and mouth.  In all three reported cases of central retinal artery occlusion with injection, the site of injection was the forehead--an "off-label" site that is commonly preformed at this time, but may be more tightly regulated against in future.  via

Lack of oxygen causes a whitening of the retinal tissue, causing the macula  to appear darker red due to contrast (called "cherry red spot" macula).  Note also the attentuation (narrowing) of the arteries and veins and the whitening of the optic nerve where it has also suffered cell death via

Let me tell you just one more thing that I love about being an OD -- optometry is such a small community, your classmates and colleagues are going to be constantly sharing their work (and life) experiences with you!  When you get done seeing your day's patients, you may have 1 or 2 of your friends patients to discuss too via texted images.  As a huge optometry nerd, yes, I enjoy this very much.

There was a ton of great eyewear on stage Sunday night at the 2014 Academy Awards, and here's a recap of some of the night's best looks.  Meryl Streep was really the only female holding strong wearing her glasses with her red carpet look, but for the men, glasses were a very common accessory!  Black frames were the overwhelming favorite, likely since more colorful glasses might have looked too casual for black tie affair.