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Sports and Amblyopia
A Mother’s Plea: “As an amblyope myself, … I can tell you that I wish, as a child, someone had told me why I couldn't hit a baseball, or catch anything thrown to me, or successfully play tennis, or badminton, or ping pong.... It would have helped immensely for me to know why I was so bad at every sport. It was painful to be the last one selected for every team, every time. Knowing why would have helped. Please educate parents. This is something their children both need to know and can understand.” -From a visitor to the website of the Ohio Amblyope Registry In Response: Why do children with a lazy eye perform poorly in sports-related activities? As a mother of an amblyopic child and as an amblyope herself, the mother’s plea, as stated above, of her own poor performance in sports clearly illustrates that amblyopia actually involves more than simply reduced visual acuity in one eye – it affects multiple vision processes as well as motor activities particularly those related to sports. Amblyopia is usually defined as reduced vision in one eye, without structural abnormalities, while the other eye is normal. Sports activities require several different vision-related motor functions such as eye-hand coordination (catching a ball), fine motor skills and the use of two eyes together for proper depth perception (i.e., where in space is that ball coming at me?). When vision is reduced in one eye as in amblyopia, it affects the person’s ability to accurately perform eye-hand coordinated activities because vision on the side of the amblyopic eye would be impaired and the person would not be able to see or see as well a fast moving object on that side such as a soccer ball or soft ball or a punch in a boxing match. Further, some amblyopes suffer from spatial distortions in the amblyopic eye such that straight lines appear curved, broken or otherwise irregular. Imagine trying to putt on a golfing green or lining up your putt when you can’t see or aim straight. Imagine trying to throw a ball to someone like a catcher when where you think he is isn’t actually where he is. Amblyopes have additional difficulties in sports because of the loss of binocular vision; that is, how the two eyes work together for depth perception (stereopsis). If one can’t see things well in 3-D space and can’t judge the distance of objects from one’s self, it goes to say that that person will not be very good in any activity that requires good depth perception as is required in nearly all sports related activities including ball-related sports (e.g., golf, softball, soccer, table tennis, volley ball, basketball) and aiming sports (e.g., bowling, target shooting, hunting). There is another, rather subtle, binocular vision process that is negatively affected in amblyopia called “Binocular Summation.” Binocular summation is the ability of both eyes to be more sensitive than either eye alone in terms of detecting very faint or very small objects. In other words, two eyes are better than one. In many sports-related activities, reaction time is critical for good performance and the sooner you see something like a fast moving ball to the outfield the faster you can move to intercept the ball and catch it. If there is a delay in your ability to see where the ball is going and in what direction, you’ll be less likely to catch the ball and your sports-related performance would suffer. Binocular summation allows the individual to see an object sooner and thus respond faster. In amblyopia, binocular summation is impaired and, as a result, sports-related performance suffers. To further complicate matters, many children with amblyopia need glasses and glasses are not popular with many children. They often misplace or loose their glasses at the most inconvenient times. As a consequence, amblyopic children may compound their visual motor problems in regard to sports-related activities when they do not wear their glasses while playing sports. Research has shown that children who need glasses but don’t have them or don’t wear them have worse visual-motor function than children who properly wear their glasses. A final message must be made regarding sports and safety glasses, those made of polycarbonate lenses, in children with amblyopia. Amblyopes with one good eye are more than twice as likely as individuals with two good eyes to suffer from eye trauma (and resulting loss of vision in the amblyope's good eye). As a consequence, to protect the remaining good eye, it is strongly recommended that amblyopic children wear eye protection, specifically sports safety glasses, when engaged in sports. Want to learn more? Check-out the following study reviews related to this topic: Amblyopia Affects Fine Motor Skills;
Children who need glasses suffer from poor motor skills; # 11 Preschoolers_Suffer_a_Loss_of_Visual_Motor_Function_if_They_have_Untreated_Refractive_Error_
-L.E. Leguire Ph.D., MBA Program Director Ohio Amblyope Registry
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