Visual Assessment

Every individual we work with is an athlete regardless of their sport / activity or skill level. Before you can improve one's visual performance, you have to assess their visual abilities.   Assessment may discover areas to help improve visual skills and, ultimately, may help them with performance.  This is more than your basic eye exam - this is the start to better visual performance.


The Sports Vision Pyramid™ was designed by Dr. Daniel Laby and Dr. David Kirschen. It is a great tool to describe the layers of Sports Vision and critical aspects to performance. Find out more about Dr. Laby and Dr. Kirschen at: and Below Dr. Smithson discusses some of the aspects of their Sports Vision Pyramid.

Case History

We commonly hear of athletes who have inconsistency in play, timing issues, struggle during stress, not living up to potential.  In addition, we hear about eye injuries, poorly fit eyewear, and more.  All of this is part of a sport/activity - specific case history.

Visual Acuity

"Sharpness of vision." Most athletes see better than 20/20 vision.   If you are seeing 20/20, then you have room for improvement.  Most athletes see 20/15 or better.  In fact, MLB players have an average visual acuity of about 20/13.

Dynamic visual acuity is the ability to track an object in motion or an object while you are in motion.  This, too, can be trained!

Contrast Sensitivity

"The degree of difference between tones." Activities are rarely black on white, so contrast assessment is considered a more "real-world" assessment of one's vision. Contrast needs to be assessed and maximized.


Depth Perception (stereopsis)

"The ability to perceive the relative distance of objects." Depth perception is made of both one eye (monocular) and two eye (binocular) cues.  Depth should be assessed to assure how well both eyes work together.  Distance depth perception is preferred.

Accommodation & Vergence

Accommodation is the "automatic adjustment of the focus of the eye." Accommodation = Focus

Vergence is the "simultaneous movement of the eyes toward or away." Vergence = aim.

Accommodation and vergence work together.  We can assess to make sure this does not hold back performance


"Concentrating the eyes directly on something."  Dr. Joan Vickers at University of Calgary has done a lot of work on the role of where our eyes fixate when we perform tasks.  For many tasks, elite performers have a steady fixation.  This can be assessed. 


Eye Movements

The ability to follow a slow moving target (pursuit eye movement) or a fast moving target (saccades), can be critical in certain sports / activities.  There are multiple ways to assess eye movements and these are critical for performance

Peripheral Awareness

The ability to be aware of what is going on in your periphery and being able to respond to it is key in sport / activities.  This can be tested with a "light board" and other ways.

Peripheral awareness may play an important part in concussion mitigation.

Eye-Hand / Foot / Body Reaction Time

"The length of time for a person to respond to a given stimulus."

Depending on the sport / activity, one's eye-hand or eye-foot or eye-body reaction time may be critical.  

This can also be broken up into a simple reaction time or a complex reaction time where one has to make a decision before reacting.


Anticipation Timing

The ability for one to expect or predict something.  Often we look at this in relation to timing. 


An ability to "remain upright and stead." This is an integration of one's visual, vestibular, and proprioception.  Often, one may assume that vision has nothing to do with balance, but it may be the key to balance issues.  It may also be integral for sea and motion sickness.

Eye Dominance

While this is a popular topic to discuss, eye dominance is a measurement that is primarily informational only. For sports where only one eye will be used (ex. certain shooting sports), this is an important piece of information. Because most other sports/activities are binocular, eye dominance has less of a role.


Vision Training


Vision Training can serve multiple purposes - we can work on improving visual/motor/neurological skills to bring them up to expected levels, we can challenge the individual to beyond what they are capable of, we can work with them on rehabilitation, and we can work as part of the collective team.  

Visual Acuity

After assessing visual acuity and a refraction, one may need glasses or contact lenses.  Contacts are the preferred choice of visual correction for most sport.  In addition, there are some techniques and apps that may help with improving visual acuity.


Speed & Span of Recognition

The ability to perceive what is happening during a dynamic activity is critical in making split second decisions.  We can assess and train how well one can identify and recall information provided in a fraction of a second.



How fast one reacts can be critical in a sport or activity.  We can work on simple and complex reactions involving central targets or reaction to peripheral targets.

Depth Perception

The ability to perceive the relative distance between objects is critical in certain sports.  Training to improve perception of depth is done in multiple ways, and the first start is to make sure both eyes work together.

Contrast Sensitivity

Contrast can be improved by having the right prescription.  In addition, there are ways to train contrast via exercises and/or apps.  Contrast can also be hampered by poor fitting contact lenses!


Eye Movements

Inaccurate eye movements can result in problems with timing and movement.  Training the eyes to move in a more accurate and efficient way can be critical for a sport.  


Motor Control

The eyes are key to moving one's hand/feet/body in response to what is happening during play.  We can use various tools to work on one's control of their hands/feet/body to improve quickness and placement.

Neurological Processing

Through multiple tools we may be able to assist with increasing processing relative to sport and activity.  This is done through technology and loading the system with split-attention tasks



Visualization is a tool that many athletes use. Sports psychology does a wonderful job of training and working on visualization and sports vision doctors can help supplement their work. 

An overview of Dr. Keith Smithson's Vision Training Room

Eye Protection


Performance in sport relies on one's eyes being functional.  In order to protect those eyes we recommend eye protection.  Eye protection is not your basic glasses, these are glasses/goggles that meet ASTM standards for that sport/activity.

We feel that wearing "street" eyewear while playing a sport puts you at greater risk of an eye injury than if you did not wear any eye protection

It is important to select the correct type of protective eyewear for you.  Please have the eyewear inspected by your eye doctor.