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Review: Vision and On-field Performance A Critical Review of Visual

Assessment and Training Studies with Athletes

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 INVITED REVIEW

Review: Vision and On-field Performance: A Critical Review of Visual

Assessment and Training Studies with Athletes
Daniel M. Laby, MD1 and Lawrence Gregory Appelbaum, PhD2*

SIGNIFICANCE: Sports vision is an emerging field that seeks to establish the relationships between visual function
and sports performance. Here we provide the first critical review of empirical studies that attempt to link visual as-
sessments and vision training to competitive game performance.
Vision is essential to producing controlled movement, and therefore, it is intuitive that better visual abilities should
relate to better sporting performance. This notion has been central to the field of sports vision, an area of study that
seeks to determine the visual skills that underlie optimal sports performance and investigate approaches to train
these abilities to improve sports performance. Although this field now contains hundreds of published articles ad-
dressing visual assessment and training in athletes, relatively few have attempted to directly link these capabilities
to on-field production statistics from competitive matches. The objectives of this article are both to describe the
theoretical and experimental framework necessary for such research and to critically review the empirical literature
that has attempted to directly link visual assessments and/or training to athletic performance. We begin by describ-
ing why such associations are important and then provide an evidence-based framework for evaluating the quality
of research in this domain. This is followed by a summary and review of the qualified literature that has addressed
either relationships between baseline assessments and game performance or the effects of visual training interven-
tions on game performance. Based on this review, it is concluded that, despite promising evidence supporting the Author Affiliations:
1
role of vision in sports performance and improvements due to training, the specialty is still in need of methodolog- Champions Edge, LLC/
ical improvements. It is recommended that studies aim for larger better-powered studies, consistent and precise SportsVisionNYC, New York, New York
2
outcome measures, and greater scientific rigor such as obtained through randomized placebo-controlled designs Department of Psychiatry and
with pre-registration of hypotheses. Behavioral Sciences, Center for
Cognitive Neuroscience, Duke
Optom Vis Sci 2021;98:723–731. doi:10.1097/OPX.0000000000001729 University, Durham, North Carolina
Copyright © 2021 American Academy of Optometry *greg@duke.edu
Supplemental Digital Content: Direct URL links are provided within the text.

quarterback must monitor teammates and opponents as a play un-

SPORTS VISION AND SPORTS VISION TRAINING
Vision is central to success in nearly all sports. Hitting a baseball,
spiking a volleyball, and executing a bicycle kick all rely on vision to
guide precise and difficult motor actions. Such perception-action cou-
pling is often regarded as a limiting factor for excellence across a wide
range of sports,1 and it all starts with the eyes. Transduction of light
into the neural code relies on optics and retinal sampling to produce
high spatial acuity and oculomotor dynamics that can maintain focus
as the body and the field of view move rapidly over space. Once trans-
duced into the neural code, information is sent through the visual
system to the brain where it is combined to form 3D representations.
These representations interact with attention, cognitive control,
memory, and motor systems in feedforward and feedback circuits
to enable perception and action—ultimately allowing for the ex-
ceptional feats of athleticism we witness when athletes perform
at their best on the field.
Just as all sports entail different movement dynamics, it is
thought that different visual abilities are essential to success. For
example, the visual needs of a softball batter are quite different
from the visual needs of a football quarterback. In one case, a bat-
ter must be able to project the trajectory of a pitch that unfolds over
milliseconds to decide whether to swing and optimally contact a
softball moving up to 70 miles per hour. In the other case, a
folds over several seconds. In all cases, the consequences can be
remarkable, with success leading to tremendous reputational and
financial gains, and failures leading to humbling physical and
mental results. Past research has supported this notion, demon-
strating that different sports draw on different visual skills, as
shown with Olympic athletes from different sports2 and among ath-
letes who play interceptive versus strategic sports.3
A core tenet of this emerging “sports vision” discipline is that better
visual abilities underlie better athletic performance. Past research has
approached this question by identifying cross-sectional differences, ei-
ther comparing subjects at different levels of athletic achievement or
testing for direct correlations between visual assessments and on-field
performance. Evidence has accrued supporting both associations. For
example, numerous studies have demonstrated that visual-perceptual
and visual-cognitive abilities are enhanced in expert athletes4,5
with evidence for superior visual acuity,6,7 enhanced contrast sen-
sitivity,8 and better visual tracking abilities9 in expert athletes.
Such findings have been synthesized in two meta-analyses of the
sports expertise literature,10,11 showing that higher achieving ath-
letes are better at detecting perceptual cues, make more efficient
eye movements, and have better attentional processing compared
with less accomplished athletes or nonathletes.
Research linking baseline assessments to game performance has
also emerged in recent years, which attempts to directly compare

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Vision and On-field Performance — Laby and Appelbaum
ocular or psychometric tests of vision to measures of game perfor-
mance. These measures include both specific statistics that isolate
the individual (e.g., plate discipline measures in baseball and soft-
ball) and nonspecific statistics that more broadly reflect productivity
in the context of other teammates or opponents (e.g., batting aver-
age, which also depends on actions of fielders and base runners).
Although conducted with a diverse range of sample sizes, assess-
ments, and outcome measures, this literature provides preliminary
evidence that better visual-perceptual,12–14 oculomotor,15,16 and
visual-motor17–19 skills correlate with better performance statistics
in competitive games and, in some cases, reduced injury instances.20
Because baseline assessments can be measured before game sta-
tistics are accrued, these findings may offer a prospective view that
can be considered predictive and therefore potentially useful for
player scouting.
Collectively, these studies demonstrating associations between
better vision and better sporting performance have provided
support for the notion that improving visual skills may also lead
to better athletic outcomes. The growing practice of “sports vision
training” relies on the notion that practice with demanding percep-
tual, cognitive, or oculomotor tasks can improve the ability to pro-
cess and respond to what is seen, which may confer an advantage
when such visual skills are marshaled in challenging sporting envi-
ronments. Although there is considerable heterogeneity in the way
that sports vision training interventions have been implemented,
the common philosophy behind these programs stems from three as-
sumptions: aspects of vision are important for particular sports,
these abilities can be modified through training, and improvements
in these visual abilities translate to better on-field performance.21
Early approaches to sports vision training entailed analog drills
that imposed heavy oculomotor demands, requiring trainees to rap-
idly alter visual accommodation and convergence, or saccadic and
smooth pursuit eye movements, to moving or physically separated
visual targets. Although several empirical studies22 and consensus
reviews23 have cast doubt on the effectiveness of such analog train-
ing techniques, a wide variety of new technologies have been devel-
oped in recent years to substantially extend the range, scope, and
contexts of sports vision training applications.24 For example, dig-
ital devices, such as stroboscopic eyewear and mobile tablet-based
devices, now allow for training during natural sporting activities.25–27
Through the use of augmented and virtual reality simulation, it is
possible to recreate and augment sporting contexts to promote
sports-specific training with high fidelity.28,29 As described in the
recent “Modified Perceptual Training Framework,”30 the effective-
ness of these approaches for improving actual competitive perfor-
mance may depend on interacting factors that define the targeted
perceptual function that is being trained, the correspondence of
the training stimulus to the desired competitive skills, and the corre-
spondence of the elicited response to competitive skills. As such, ef-
fective sports vision training approaches involve a multidimensional
set of relationships that must fit into a training program that is logis-
tically feasible and tolerable for athletes who generally have consid-
erable demands for their time.
Research across the gamut of sports vision has led to widely dis-
crepant findings regarding the reliability and effectiveness of these
approaches. There are many possible reasons for these discrepan-
cies, including the specificity of the assessment or the training, the
match between the approach and the sport under consideration,
and the scientific or statistical methodologies used in conducting
the study. The next section of this article will briefly address some
of the important concepts regarding evidence-based science that
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are important for interpreting the sports vision literature but pose
challenges when working with athlete populations. This is followed
by a summary of each of the considered publications and a critical
review of the strengths and weaknesses of this literature along with
recommendations that may lead to improvements in future re-
search and practice.
EVIDENCED-BASED SCIENCE AND BEST
PRACTICES IN SPORTS VISION RESEARCH
As with any discipline, the practice of sports vision should be
driven by the best available evidence. However, the opportunity
to conduct carefully controlled and sufficiently powered research
studies, especially in the case of elite athletes, is a challenge that
requires considerable effort. Because of logistic hurdles, limits of
available time, and the potential desire of athletes and teams to
maintain a competitive advantage, there is a relative scarcity of op-
portunities to conduct well-designed studies that can be published
for public consumption. Despite these challenges, the pursuit of
well-designed and executed studies should remain the criterion
standard in sports vision research. As an initial step, it is important
to consider challenges to causal inference that may impact the
sports vision literature. For a more complete treatment of human
subjects research methods and sampling biases, see the text by
Patten and Newhart.31
Causal inference refers to the process of drawing a conclusion
about the connection between a condition and an effect. Good re-
search designs are organized to allow for strong inference while
minimizing sources of bias. Although randomized assignment of
participants is considered among the criterion standards in causal
research, studies with athletes pose a particular problem in this re-
gard. For all intents and purposes, it is often not possible to ran-
domly assign participants to treatment and placebo groups, or to
different sports or levels of achievement, and therefore, there are
selection processes that may be beyond experimental control. As
such, it is important to consider selection biases that impact the in-
terpretation and generalizability of findings. Broadly speaking, se-
lection bias refers to the choice to analyze some data with regard
to all possible data that may be available. Within the hierarchy of
sports, one must also consider survivorship bias, a form of selection
bias that specifically addresses concentration on people that have
passed a selection criterion. Although these aspects of representa-
tive sampling pose challenges within the sports vision literature, it
is important to encourage the interpretation of results regarding the
specific sample under consideration and avoid, or acknowledge,
potential sampling biases.
A second area of methodological challenge stems from the de-
sire to test multiple relationships among the abundance of mean-
ingful quantitative data generated in sporting activities. To infer
relationships, null hypothesis tests are typically performed to deter-
mine the statistical likelihood of a result not having occurred by
chance. Within this framework, type I errors and type II errors occur
when incorrectly selected criteria are used to reject hypothesis.
Type I errors are controlled by the level of statistical significance
or certainty, typically 95% certainty or P < .05. With multiple anal-
yses, however, the chance of a false-positive finding will be in-
flated, creating the appearance that a significant finding exists
when indeed none is present. In such situations, it is necessary to
adjust the significance level to account for the multiple tests being
performed, so-called multiple comparison correction. Type II errors
724

occur when one accepts a null hypothesis that is false. Such errors are
related to the number of subjects enrolled in the study, with insuffi-
cient sample sizes making type II errors more likely. To have the best
chance of rejecting the null hypothesis and of avoiding type II errors,
studies must have enough subjects. Because of challenges in
obtaining large sample sizes and the desire to test many aspects of
performance simultaneously, studies addressing sports vision must
take special precautions to avoid inflation of these statistical errors.
The biases listed previously largely reflect comparable challenges
faced in other domains of human behavioral research32 and have
sparked a movement toward “Open Science” principles that priori-
tize transparent, rigorous, and accountable research practices to pro-
mote accessible, verifiable, and valid findings. Driven partly by the
tenets of clinical trials that permeate medical research, Open Sci-
ence advocates for approaches such as pre-registration of hypotheses
and methods before initiating studies, placebo control to isolate in-
terventional effects, and open access to data and code to make the
raw materials and outputs of studies available for others to repli-
cate and build upon. Given the many methodological challenges
noted previously, sports vision studies are advised to follow the Open
Science principles. See the Appendix (available at http://links.
lww.com/OPX/A496) for more on pre-registration and the Open
Science approach.
LITERATURE SUMMARY
In the following section, we review the literature that has tested
the role of vision and/or vision training using sports performance
statistics as outcome measures. To arrive at a representative sam-
ple of articles addressing vision assessment and vision training,
we first included all references in the 2011 American Optometric
Association, Sports Vision Section bibliography.33 These references
were combined with results of keyword searches on PubMed for ci-
tations with the terms “sport” AND “vision,” “sports” AND “atten-
tion,” and “sports” AND “neuroscience,” performed on April 13,
2020. Forward and backward bibliographic searches using Google
Scholar were performed on these articles and topical reviews in this
field from Mann et al.,10 Voss et al.,11 Williams and Ford,34 and
Appelbaum and Erickson.24
Articles were considered for review if they were written in English,
described research with human subjects, and included statistical
comparisons of quantitative visual and/or psychometric assessments
with game performance measures obtained from competitive or simu-
lated sporting events. Approximately 540 references were initially
identified and screened. Title and abstract review eliminated most
of these articles because they either did not include on-field sports
performance metrics as outcome measures or did not include use of
appropriate vision assessment or training interventions. The final re-
viewed sample included 13 articles that addressed correlations be-
tween visual assessments and game statistics, and 16 articles that
addressed gains due to vision training using benchmarks from game,
or game-like, statistical production. Although this process was
designed to capture relevant articles, it was not intended to be
exhaustive but instead create a representative sample of the relevant
scientific literature.
Studies Linking Vision Assessment to
Game Performance
A total of 13 publications that reported comparisons between vi-
sual assessments and sports performance were found. Of these
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Vision and On-field Performance — Laby and Appelbaum
articles, eight involved baseball athletes, two reported on basketball,
and one each reported on hockey, marksmanship, and softball.
Baseball Studies
In an early study by Laby and colleagues35 published in 1998,
410 major and minor league players in the Los Angeles Dodgers
baseball organization were assessed for ocular dominance using a
modified Bryngelson technique (placing a tube over their eye to
gaze at a distant target) and hand dominance. Eye-hand dominance
was defined as uncrossed if the laterality matched for the eye and hand
assessment or crossed if it did not. Dominance was then compared
with batting and pitching performance using subsequent season game
statistics. Results did not demonstrate significant associations be-
tween eye, hand, or eye-hand dominance and batting or pitching
statistics in either the major or minor league samples.
The same year, Molia and colleagues36 published an article
testing stereopsis in a sample of 23 collegiate baseball players that
included 14 position players and 9 pitchers. In this study, a battery
of functional vision tests was acquired, including Snellen acuity
and eye alignment at distance, and three different near and far
distance stereoacuity measures. These assessments were compared
through separate Spearman correlations to the players' previous-year
game statistics for batting average and slugging percentage among
the position players and earned run average, out percentage, and
strike-out percentage for the pitchers, including only batters with
>50 at bats and pitchers with >9 innings pitched. Although results
demonstrated better-than-average functional vision scores and
correlations between stereoacuity measures, they did not dem-
onstrate significant relationships with any of the game performance
measures.
In 2011, Reichow and colleagues13 reported on results from a
pilot study conducted with 20 members of the Pacific University
baseball team to test if players' ability to correctly identify tachisto-
scopically presented pictures of a pitch was correlated with their
batting averages from the previous season. In this study, players
were presented with 30 randomly ordered slides depicting a pitcher
throwing 1 of 4 different pitches, each presented for 200 millisec-
onds. A single Pearson correlation test was performed, which dem-
onstrated a significant (P < .01) and strong (r = 0.648) positive
correlation, with better average tachistoscope accuracy scores cor-
responding to higher season batting averages.
In 2016, Müller and Fadde37 reported on findings from a tem-
poral occlusion study performed with 34 minor league baseball
batters with at least 100 at bats from which to draw statistics. In
this study, the authors compared players' accuracy in judging the
pitch type (fastball, curveball, change-up) when occluded at four
different time points relative to ball release (at pitcher's front foot
impact, shoulders squared, ball release, and a no-occlusion con-
trol) against their on-field batting performance statistics including
batting average, on-base percentage, slugging percentage, base
on balls, strikeouts, and walk-to-strikeout ratio. Pearson correlation
coefficients were calculated for each combination of occlusion
time point (4) and game statistic (6) using only results from the
fastball and change-up pitches and a criterion for statistical signif-
icance of P < .05, without correction for multiple comparisons. Re-
sults demonstrated significant positive correlations between task
performance at the front-foot release point and base on balls
(r = 0.35, P = .04) and significant positive correlations in the ball
release condition with base-on-ball percentage (r = 0.37, P = .03)
and on-base percentage (r = 0.37, P = .03).
725
Vision and On-field Performance — Laby and Appelbaum
To evaluate the role of eye-hand coordination on batting perfor-
mance, Laby and colleagues19 reported on a 2018 study with 450
professional baseball players (105 major league) in which per-
formance on a commercially available assessment system (Sports
Vision Trainer System; Sports Vision PTY, Sydney, Australia) was
compared retrospectively with career plate discipline metrics. Using
Bonferroni-corrected Pearson correlations, the authors compared
eye-hand performance from three different assessment modes (pro-
active, reactive, go/no-go) to individual player's career plate discipline
measures for out-of-zone chase percentage, fastball chase percent-
age, in-zone swing percentage, in-zone fastball swing percentage,
and at bats per base on ball, as well as players' highest achieved
league level and years of major league service. Results demonstrated
statistically significant correlations between most of the task scores
and plate discipline metrics (P < .001), as well as longer service in,
and likelihood to achieve, the major league level.
The same year, Burris and colleagues17 made use of a natural-
istic sample of data collected on the Nike (Beaverton, OR) SPARQ
Sensory Station, a normative battery of nine validated tasks,38–40
to evaluate the links between visual-motor performance and bat-
ting performance in a sample of 252 professional baseball players
(141 batters with >30 at bats and 111 pitchers with >30 innings
pitched). Using a Bayesian hierarchical modeling approach that
allowed for comparison across players from different leagues and
contrast to a baseline model, task performance on the Sensory Sta-
tion was compared with subsequent season game statistics for
on-base, walk, strikeout, and slugging percentages for batters and
fielder-independent pitching for pitchers. Results demonstrated
that, compared with the base model including the player age and
position as control variables, a full model including performance
on the task battery produced probabilistically (outside 95% confi-
dence interval) better prediction of on-base percentage, walk rate,
and strikeout rate, with better performance on the task battery cor-
responding to better performance on the field.
In 2019, Laby and colleagues14 tested the relationship be-
tween performance on a functional vision screen (Enhanced Vision
Testing System) that combines target size, target contrast, and pre-
sentation time with individual career plate discipline batting statis-
tics in a sample of 475 professional baseball players. Results
demonstrated statistically significant Spearman (rank order) corre-
lations between performance on the visual evaluations and plate
discipline measures including in-zone swing percentage, in-zone
fastball swing percentage, chase percentage, fastball chase per-
centage, and at bats per base on ball. Further analyses comparing
players in the top and bottom quintiles of vision screening scores
showed significantly better plate discipline in metrics including
at bats per base on ball and in-zone swing percentage, indicating
that batters with better visual function are more likely to be suc-
cessful when batting.
Most recently, among the baseball studies, Liu and colleagues16
evaluated the relationship between pre-season visual and oculomotor
evaluations and pitch-by-pitch batting performance in the subsequent
season from a sample of 71 professional baseball batters. In this
study, eye tracking (RightEye, Bethesda, MD), visual-motor (Senaptec,
Beaverton, OR), and optometric evaluations were compared through
nested regression models with pitch-level data from Trackman 3D
Doppler radar used to generate batting propensity scores including
out-of-zone swing rate, in-zone swing rate, in-zone swing, and miss
rate, as well as the batters' highest attained league levels during
the season. Results indicated that visual evaluations relying on eye
tracking (smooth pursuit accuracy and oculomotor processing speed)
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significantly predicted the highest attained league level and out-of-
zone and in-zone swing propensity rates. These findings were taken
as evidence that batters with superior visual and oculomotor abilities
are more discerning at the plate.
Other Sports
Among the four identified studies that addressed sports other
than baseball, the first report came in 1995 from Berg and Killian,41
who compared visual field size among a hybrid sample of 12 collegiate
softball players and 12 collegiate nonathletes. In this study, visual
field was measured through kinetic perimetry using a Topcon (Oakland,
NJ) manual perimeter. Among the softball players, batting performance
was assessed through both a noncompetition batting test done off of a
pitching machine and batting averages from Division 1 competitive
games (perimetry was assessed in the middle of the team's season).
Results indicated that, although visual fields were significantly larger
in the athletes than nonathletes, field size did not correlate with either
competitive or noncompetitive batting averages.
To assess the role of eye movements in marksmanship, Causer
and colleagues15 reported on a 2010 study measuring visual search
behaviors and gun barrel kinematics in 24 elite and 24 subelite
shooters. Point-of-gaze and gun barrel movements were recorded
during skeet, trap, and double-trap events performed at the Interna-
tional Shooting Sport Federation shooting range during noncompet-
itive but Olympic-rules shooting events. The duration and onset of
quiet eye, defined as the final fixation on a target before movement
initiation,42 were calculated in relation to the scene camera on each
shot and compared with gun motion profiles captured by two station-
ary external cameras. These were submitted to ANOVA to examine
the effects of skill (elite/subelite) and shot outcome (hit/miss), with
effect sizes calculated as partial η2. Results demonstrated that, in
all shooting disciplines, elite shooters produced both earlier quiet
eye onsets and longer durations than did subelite shooters. More-
over, in all disciplines, quiet eye duration was longer and onset ear-
lier during successful, compared with unsuccessful, trials for all
shooters, providing evidence that the stability of gaze before shot ini-
tiation is important for shooting success.
In 2014, Mangine and colleagues12 reported on results of a
study testing the relationship between visual tracking speed and re-
action times with game statistics in 12 professional basketball
players. Visual tracking speed was obtained from 20 trials on the
NeuroTracker (CogniSens Athletic, Inc., Montreal, Canada) multiple-
object tracking test, whereas reaction times were measured with the
Dynavision D2 light board (Dynavision International LLC, West Chester,
OH). These assessments were compared with game statistics from the
subsequent National Basketball Association season, including assists,
turnovers, assist-to-turnover ratio, and steals. Results indicated positive
relationships between visual tracking speeds and assists (r = 0.78,
P = .003), steals (r = 0.77, P = .003), and assist-to-turnover ratios
(r = 0.78, P = .003) but no relationship between reaction time and
any of basketball performance measures.
Poltavski and Biberdorff18 reported on results from a 2015
study comparing assessments on the Nike Sensory Station with
game statistics from 38 Division 1 collegiate male and female ice
hockey players (19 each). In this study, the authors performed mul-
tiple regression analyses with backward elimination to isolate which,
if any, of the nine assessment tasks on the Sensory Station predicted
each of three different game statistics, aggregated over two succes-
sive seasons. For offensive players, these included the percent of
goals scored and the average number of points per game. For all
726

players, the average number of penalty minutes per game was also
calculated. Results demonstrated that 69% of variance in the goals
made could be predicted by better performance on four for the as-
sessment tasks, whereas 33% of variance in game points and 24%
of variance in the duration of penalty time could be accounted for
by other tasks.
Finally, Vickers and colleagues43 reported on the role of quiet eye
analysis in basketball three-point shooting in a 2019 noninterventional
descriptive report. Twelve university or semiprofessional basketball
players, both male and female, were enrolled. Performance of
three-point shots was recorded in both defended and undefended
conditions. Both the accuracy of the shot and different visual fixa-
tions of the shooter were recorded and compared. The authors
found that shooting accuracy was enhanced when optimal visual
fixation patterns (i.e., quiet eye) were observed. They also note that
this was not affected by defenders' actions.
Collectively, these studies stemming from highly variable as-
sessment approaches, athlete samples, and scientific methodolo-
gies provide mixed evidence supporting the role of different visual
skills toward sporting performance.
Studies Testing the Effects of Vision Training with
Statistical Production during Competition
A total of 16 publications that addressed vision training inter-
vention and their effects on sports performance were identified.
Of these, eight involved baseball, two reported on cricket, and
one each reported on volleyball, hockey, soccer, badminton, golf,
and racquet sports.
Baseball Studies
Seven articles dealt with vision training and baseball perfor-
mance metrics, all of which reported some level of improvement
with vision training.
In 2006, Fadde44 reported on the effects of training perceptual
decision making on baseball performance. All position players from
a National Collegiate Athletic Association baseball team were rank
ordered by their coaches based on overall hitting ability, and then
adjacently ranked players were assigned to either a treatment group
that underwent 2 weeks of pitch occlusion training or a control
group that performed typical baseball activities. Batting statistics
for the next 18 games were compared using the Mann-Whitney U
test. The author reports that significantly better batting averages
were observed in the trained group, as compared with the control
group, during the post-training games (P < .05), whereas slugging
percentage and on-base percentage were numerically superior but
not statistically significant.
A 2012 article by Clark and colleagues45 reported on the use of
a vision training program with the University of Cincinnati baseball
team. All players on the team underwent a diverse vision training
program consisting of circuit training with both analog (e.g., Brock
String, near-far charts, and saccades) and digital (e.g., drills with
stroboscopic eyewear, Dynavision light board, and tachistoscope)
training activities for 6 weeks before the season and during the
baseball season. Overall team results, such as cumulative batting
average and slugging percentage, are reported and compared with
the rest of the conference during that same season. The authors re-
port a significant increase in batting average and slugging percent-
age for the Cincinnati team relative to the rest of the conference
(P = .02), with similar findings from analyses of conference and
nonconference games.
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Vision and On-field Performance — Laby and Appelbaum
In a 2014, Deveau and colleagues46 report findings on the ef-
fects of a perceptual training program on on-field batting perfor-
mance and generalized visual abilities. Nineteen collegiate batters
from the University of California, Riverside baseball team completed
30 sessions, whereas 18 pitchers served as a control group. In this
training program, individuals practiced a digital, near-threshold tar-
get detection task in which they searched for patterns of differing
spatial frequencies and orientations that increased in contrast but
decreased in point values over time. The authors made direct com-
parisons between the batters and pitchers on transfer visual acuity
tests, which demonstrated significant improvements for the trained
batters over the untrained pitchers. To assess baseball performance,
the authors compared on-field game statistics before and after train-
ing for 11 of the batters in relation to 78 batters from the Big West
conference who were matched for age and position. Results demon-
strate that the vision training group had significantly fewer strikeouts
(P = .03) and more runs created than did the comparison group, with
aggregated improvements equaling four to five projected wins.
Belling and Ward47 reported in 2015 on the effects of video-based
training for pitch recognition and pitch location in nine National Col-
legiate Athletic Association Division 1 players who had on-field per-
formance data. Training consisted of temporal occlusion training of
pitch recognition and location on a 65-in touch screen display under
an adaptive procedure with progressively earlier occlusion after suc-
cessful responses. ANOVA, uncorrected for multiple comparisons,
and calculation of Hedges g effects sizes, without the benefit of a
control comparison group, were performed. The authors reported sig-
nificant improvements in the number of home runs (P = .008), runs
scored (P = .04), and slugging percentage (P = .04) with moderate or
large effect sizes. Analysis of walks, batting average, and on-base
percentage were numerically larger for the intervention group, al-
though these differences did not reach statistical significance.
In 2016, Fadde48 reported on the effects of pitch recognition
training in a team of 18 collegiate baseball players. Analysis was
performed on total team statistics rather than individual player per-
formance, and comparison was made against batting performance
of other teams in the conference, without the benefit of a matched
control group. Eight different batting metrics were used in comparing
the study population with the control teams. Using a Mann-Whitney U
test that compared the likelihood of rank ordering from the interven-
tion group being higher than the control group, the authors reported
a significant gain in walk-to-strikeout ratio between years for the treat-
ment group over the control (d = 0.953, P = .02), although none of the
other statistics reached significance and the tests were not adjusted
for multiple comparisons.
In 2017, Gray49 reported on the use of a virtual environment to
assess potential improvements in batting performance. In this
relatively large interventional study, 80 high school batters were
assigned to 4 different groups that trained with adaptive hitting
training in the virtual environment, extra sessions of batting prac-
tice in the virtual environment, extra sessions of real batting prac-
tice, or a control condition involving no additional training to the
players' regular practice. Eight different virtual and real batting
metrics, including in-zone swing percentage and chase rate, were
analyzed with Bonferroni correction performed for multiple compar-
isons. Results showed that trained players in the adaptive virtual
environment group demonstrated significantly greater improve-
ment from pre-training to post-training compared with the other
control groups on most of the on-field measures using independent-
samples t tests at the Bonferroni-corrected critical P value of .006.
These players also had superior batting statistics in league play and
727
Vision and On-field Performance — Laby and Appelbaum
reached higher levels of competition after training (χ2 test of pro-
portions, χ2 = 7.9, P = .05).
Most recently, in a 2020 report, Liu and colleagues50 reported
on the results of a dynamic visual skills training program versus pla-
cebo training in 24 Division I collegiate baseball batters. Unlike all
other studies summarized thus far, this study was pre-registered to
report all the methods and a priori hypotheses before the study
(https://doi.org/10.17605/OSF.IO/JXH8U) and included randomiza-
tion into either an active dynamic vision training group or a matched
placebo training control group. Three different types of metrics were
used in comparing the treatment and control groups: visuomotor
evaluations, instrumented batting practice measures, and National
Collegiate Athletic Association game statistics. The authors found
no difference between the groups in the visuomotor evaluations or
in the game statistics. Significant differences were, however, ob-
served for launch angle (P = .002) and hit distance (P < .001) in
the instrumented batting practice tasks that each constituted me-
dium effect sizes according to Cohen's standards (d′ = 0.74 and
0.70, respectively). As such, this pre-registered study provides evi-
dence that vision training improved batting practice performance
on metrics showing longer hit distances and higher flight angles,
but further studies with larger samples are needed to corroborate
and extend these findings.
Cricket
In 2008, Balasaheb and colleagues51 reported on the effects of
visual skills training on cricket batting. Vision training lasted 6
weeks and occurred 3 days each week. Thirty subjects were divided
into three groups: a treatment group that received visual training, a
placebo group given a reading task and a video task not believed to
improve vision, and a control group that performed their typical
cricket training with no added visual tasks. The authors found that
all three groups showed statistically significant improvement in
batting performance, but only the treatment group demonstrated
improved visual skills after training in all skills, whereas the pla-
cebo and control groups showed improvement in some, but not
all, visual abilities. As such, these findings do not indicate selective
improvements in cricket performance because of vision training
over the control interventions.
Hopwood and colleagues52 published results in a 2011 study
with 12 senior international cricket players in which they compared
pre-versus-post visual training abilities on a video-based decision
test and on-field performance metrics. Training lasted 6 weeks,
and seven players performed an on-field training program in addi-
tion to perceptual training, whereas five players underwent only
on-field training. The authors report that the trained group demon-
strated a statistically significant improvement in video-based decision
making when compared with their pre-test ability and compared with
the control group. The decision accuracy of the control group showed
a large decrease over the course of the study, despite an expectation
for this to remain relatively stable. In addition, although the mean fiel-
ding success score showed a statistically significant improvement in
the trained group, the mean movement initiation time did not show
any difference.
Other Sports
In 2001, Abernethy and Wood22 reported on the effects of a vi-
sion training program on racquet sports. Subjects were divided into
four groups with 10 subjects in each group and underwent either
an analog oculomotor training program based on drills originally
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Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.
described by Revien and Gabor,53 a video-package-based “eyerobics”
training program, placebo training, or no training. Training lasted for
4 weeks, and pre-performance and post-performance measures were
recorded, including tennis forehand drive accuracy. The authors
found no evidence of either improved vision or sports-specific perfor-
mance in any of the groups.
In 2011, Vine and colleagues54 described results from quiet
eye training in golf putting with treatment and control groups, each
consisting of 11 elite golfers. The treatment group received golf
putting quiet eye training, whereas both groups received video-based
gaze feedback. Putting was scored both before the study and after
training. The authors found no difference between the groups at the
outset but reported a significant difference after training, with
the intervention group requiring 1.9 fewer putts per round under
game conditions than the control group.
Ryu and colleagues55 published a 2018 report in which 36 nov-
ice badminton players were divided into 3 groups that received dif-
ferent perceptual training during a 3-day period. In addition to the
control group that was provided normal video of badminton shots,
the training groups viewed either low or high spatial frequency–
filtered videos of badminton shots. In all cases, videos were oc-
cluded at the moment of contact between the racquet and the
shuttle, and subjects were asked to identify the direction of the
shuttle movement. The authors noted that there was a significant
difference in accuracy between the control group and that of the
low spatial frequency–trained group (P = .005). This was theorized
to result from longer gaze at the point of racquet-shuttle contact in
the low-spatial-frequency group.
In 2016, Romeas and colleagues56 studied the effects of
multiple-object tracking training on soccer performance. They
describe the use of a 3D training program on university-level ath-
letes, with nine participants in the active multiple-object tracking
training group, seven in the active control group who watched 3D soc-
cer videos without multiple object tracking, and seven subjects in a
passive, no intervention, control group. Results indicated improved
decision-making ability for passing in the actively trained group com-
pared with the combined control groups. There was no difference in
dribbling or shooting decision-making accuracy between the groups.
In 2013, Mitroff and colleagues57 reported on the results of a
pilot study conducted with 11 National Hockey League players,
performed during pre-season training camp, as players were attempting
to qualify for a professional team. Here, six players underwent a
14-day training program in which they did on-ice hockey drills
while wearing Nike Vapor Strobe eyewear (Nike Inc., Beaverton,
OR), whereas a control group of five players did comparable drills
with normal vision. Before and after training, players were scored
on puck placement drills receiving higher points for better accu-
racy when shooting at distant targets. Using analysis of covariance
that controlled for pre-training performance, the authors found a
significant gain for the intervention group over the controls, which
amounted to an 18% improvement for strobe training, but no
change for the control group.
Jenerou et al.58 studied the effect of a vision training program on
the performance of a collegiate level (Division I) ice hockey team. In
their 2015 study, they enrolled 22 male players who underwent a
6-week, generic and nonpersonalized binocular, accommodative,
and dynamic visual skills training program. Although it was not pos-
sible to determine which training tasks had no effect, some effect, or
a significant effect on performance, the authors note that, subjec-
tively, players reported a positive impact on their game performance.
In addition, there was a statistically significant improvement in goals
728

(t = −3.778, P < .003), shots on goal (t = −3.262, P < .01), and
shooting percentage (t = −2.598, P < .03) when compared individ-
ually from pre-training to post-training.
Finally, Formenti and colleagues59 reported in 2019 on the effects
of perceptual vision training in volleyball. This study enrolled 51 female
volleyball players who were randomly assigned to either a 6-week con-
text sport-specific training group that performed repetitive volleyball
drills without analytic vision exercises, a vision training group that
performed analytic vision exercises during non-volleyball training,
or a vision training sport-specific group that performed analytic vision
exercises during volleyball training activities. Each player underwent
pre-training and post-training assessment of both volleyball-specific
abilities (accuracy of passing, setting, and serving) and more general
cognitive abilities (reaction time, executive control, perceptual speed).
Results indicated that, although perceptual vision training improved
the cognitive abilities of the perceptually trained players as compared
with the conventionally trained players, the conventionally trained
players demonstrated superior volleyball-specific abilities as com-
pared with the perpetually trained players.
CRITICAL REVIEW AND FUTURE DIRECTIONS
The representative collection of sports vision studies summarized
previously includes a diverse range of research questions, experimen-
tal approaches, and findings. They offer a heterogeneous set of con-
clusions: many support the hypothesis that assessments correlate
with game performance, and others do not; some support the hypoth-
esis that vision training improves game performance, and others do
not. Reviewing these publications reveals several commonalities that
can be used to gain a greater appreciation of the role of vision and vi-
sual training in sports performance, as well as the strengths and limi-
tations of research in this field. In the following sections, we review
issues related to the sample sizes, assessments and interventions, out-
come measures, statistical approaches, and conclusions. We end by
summarizing improvements that may move the field forward.
Review of Studies Addressing Visual Assessment and
Sports Performance
As noted previously, the power of any statistical inference de-
pends on the effect size and the number of observations. In the
case of the 13 articles addressing visual assessments, 4 stud-
ies14,17,19,35 included large samples with between 252 and 475
professional baseball players, whereas the others had 71 or fewer
individuals. Several, but not all, studies included players with only
a large number of plate appearances, whereas others included low
numbers or did not report this information. Among the non-baseball
studies, the average sample size was 19.6 athletes.
Access to research with large athlete cohorts is not common,
and therefore, it is important not only to take advantage of opportu-
nities when they are presented but also to scale research questions
to fit the sample that is available. For instance, as reported by
Reichow and colleagues,13 the research sample consisted of only
20 collegiate batters, but the study addressed a focused question
and single statistical test that did not require multiple comparison
correction. In contrast, Laby and colleagues19 included a sample of
450 professional batters while testing a range of relationships be-
tween hand-eye coordination and batting performance while
correcting for multiple comparisons. These two studies presented
appropriately scaled research questions, but this was not always
the case across the whole literature.
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Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.
Vision and On-field Performance — Laby and Appelbaum
Although visual perception is unitary, the visual system is made
up of many different, interrelated, fundamental processes, includ-
ing static and dynamic acuity, binocular vision, ocular-motor func-
tion, attention, visual working memory, and higher-level cognition.
The range of assessments used in the reviewed studies reflects this
heterogeneity. These include optometric measures of ocular func-
tion, such as ocular dominance, perimetry, eye movements, and
measures of refractive error, using both sport-specific stimuli and
non–sports-specific stimuli. Although these assessments and stim-
uli are generally well motivated in the context of each study, and
many individual studies show positive relationships between visual
assessments and game performance, collectively, they use widely
different assessments, making it difficult to build consensus or
demonstrate reproducibility around certain relationships.
Another challenge in this literature stems from the variable and
nonspecific game performance measures that are available for ath-
letes who play different sports or positions. Among the 13 assessment
studies reviewed, 8 tested baseball and 1 tested softball. These sports
are generally favorable for research because common metrics of bat-
ting and/or pitching are used that broadly capture production among
batters or among pitchers. Nonetheless, certain statistics are more
suitable for isolating production of individual athletes and even de-
cision making during each at bat occurrence. With the advent of
radar-based tracking systems, these “advanced analytics” have
grown in popularity, and this is reflected in the reviewed studies.
The five articles published before 2018 all used counting statistics
such as batting averages, home runs, and earned run averages, which
depend on the actions of fielders and base runners. Three of the four
studies published since14,16,19 used plate discipline and swing pro-
pensity measures that isolate the actions of the batter, without regard
to other actions on the field. Continued use of such plate discipline
metrics should be encouraged, as they are most able to directly link
vision and performance in an individual athlete.
Across the studies addressing links between assessment and
game production, several different statistical approaches were used.
The most common was application of Pearson (linear) or Spearman
(rank order) correlations, which attempt to measure the dependent
relationships between assessment scores and game performance
scores, across individuals. In most cases, multiple outcome mea-
sures were tested; however, multiple comparison corrections were
not implemented to account for these tests. Some studies, however,
did apply corrections.14,19 At least four studies16–18,43 implemented
regression analyses, which allow for estimation of multiple predictor
variables, including one that performed a Bayesian regression ap-
proach.17 As such, these studies offered a deeper accounting of
multiple interrelated factors that may contribute to game statistical
performance. Two studies15,43 also provided information about ef-
fect sizes, which go beyond statistical inference to provide informa-
tion about the strength of relationships between variables.
In conclusion, these studies offer promising but incomplete evi-
dence that performance on visual assessments may correlate with
game performance in competitive situations. Despite such promise,
strong conclusions cannot be drawn across this literature because of
the considerable heterogeneity in assessment and outcome measures,
sample sizes, and statistical approaches.
Review of Studies Addressing Visual Training and
Sports Performance
In addition to the attributes noted previously, sufficiently powered
subject sample sizes, randomization, and the use of matched-control
729
Vision and On-field Performance — Laby and Appelbaum

groups are additional important components of a well-designed in-
terventional study. Although it is often difficult to recruit athletes
for such studies, especially at the elite and professional levels,
the quality and validity of study findings are critically dependent
on optimal pre-study planning and study execution. For training
studies, authors should consider the anticipated effect of their in-
tervention on the sports performance metric they wish to study
and calculate sample sizes required to have a sufficiently powered
study that delivers meaningful results. Software packages, such as
G*Power (University of Dusseldorf, Düsseldorf, Germany) are avail-
able to help with this estimation, whereas statistician colleagues
can help guide optimal study design.
In the intervention studies summarized previously, there was an
average of 30 subjects, split approximately evenly between treatment
and control groups. Considering that the influence of various visual
functions on sports performance is likely relatively small, when com-
pared with other factors, it is somewhat surprising that, despite these
small sample sizes, most reports showed significant gains due to the
training intervention. Some studies49,51,59 were slightly larger in
scope, offering a better chance to demonstrate the effects of the inter-
vention, whereas the remaining studies generally had a low number of
subjects, leading to questions about the validity and replicability of
these results. Despite challenges in obtaining access to larger sample
sizes, especially among professional and collegiate athletes, future
studies should attempt to achieve large samples, possibly by perform-
ing cooperative multisite studies.
In designing interventional trials, the correspondence between
treatments and outcome assessments plays a central role in the
study's success. The reviewed studies explored visual training in-
terventions including stroboscopic training, ocular-motor training,
eye-hand coordination training, anticipatory timing training, and
adaptive perceptual learning. Nine studies implemented training
in naturalistic interventions, whereas seven used general interventions
that seek to transfer foundational skills and trained out of context.
Among the reviewed studies, seven contained on-field performance
metrics, and nine contained competitive game metrics. Although
several studies made straightforward links between treatments and
outcomes, others failed to demonstrate good matches, for example,
using whole team performance statistics to detect individually di-
rected training interventions.48 Most of the reviewed studies used con-
trol groups, although in some cases these may not have been matched
and/or randomized optimally. Lastly, studies did not always apply a
personalized sports-specific approach to the interventions used,
instead opted for a generalized wide-ranging set of interventions
performed equally by all participants.58
Within this literature, careful consideration needs to be paid to
the statistical analysis plan, particularly in situations where multi-
ple analyses can be performed. Many of the interventional studies
summarized previously may have failed to correct for multiple com-
parisons, inflating the possibility of type I (false-positive) error and
misinterpreting a finding as being hypothesis driven. In several
cases, findings were described as exploratory, inviting follow-up re-
search, and a single study was labeled as a pilot study.57 Some stud-
ies, including that by Gray,49 appropriately corrected for the multiple
analyses, whereas only Liu and colleagues50 pre-registered hypothe-
ses and analyses, further strengthening the evidence. Encourag-
ingly, these studies both showed positive effects, using specific
outcome measures and pointing to the promise of virtual reality
and digital training augmentations of vision training. To move the
field forward, future studies should adopt these best practices.
Suggestions to Improve the Field Going Forward
To understand the role of vision in sports, develop and test inter-
ventions to improve performance, and provide honest evaluation,
the field of sports vision needs to continue to evolve. The combina-
tion of vision assessments, interventions, and game performance
data makes this a multidisciplinary endeavor that spans the traditional
bounds of science. Increased demonstrations from pre-registered, ap-
propriately powered, and controlled studies will continue to bolster the
value of these techniques, whereas reporting of negative findings will
aid in determining reproducibility. Ultimately, adopting these ap-
proaches will better demonstrate the value of these services to teams
while growing the specialty and attracting more high-quality practi-
tioners and researchers.

ARTICLE INFORMATION
Supplemental Digital Content: The Appendix, available at
http://links.lww.com/OPX/A496, is a description of chal-
lenges that result from working with athlete populations,
biases that may result, and Open Science techniques
that may continue to improve the discipline.
Submitted: November 18, 2020
Accepted: March 7, 2021
Funding/Support: U.S. Army Research Office (W911NF-
15-1-0390; to LGA).
Conflict of Interest Disclosure: The authors have no financial
conflict of interest to disclose.
Author Contributions and Acknowledgments: Conceptualization:
DML, LGA; Data Curation: DML, LGA; Formal Analysis:
DML, LGA; Funding Acquisition: LGA; Investigation: DML,
LGA; Methodology: DML, LGA; Writing – Original Draft:
DML, LGA; Writing – Review & Editing: DML, LGA.
The authors would like to thank Sicong (Zone) Liu for his
comments on an early draft of this article.
REFERENCES
1. Le Runigo C, Benguigui N, Bardy BG. Perception-
action Coupling and Expertise in Interceptive Actions.
Hum Mov Sci 2005;24:429–45.
2. Laby DM, Kirschen DG, Pantall P. The Visual Func-
tion of Olympic-level Athletes—An Initial Report.
Eye Contact Lens 2011;37:116–22.
3. Burris K, Liu S, Appelbaum L. Visual-motor Expertise
in Athletes: Insights from Semiparametric Modelling of
2317 Athletes Tested on the Nike Sparq Sensory Sta-
tion. J Sports Sci 2020;38:320–9.
4. Williams AM, Ford PR, Eccles DW, et al. Perceptual-
cognitive Expertise in Sport and Its Acquisition: Implica-
tions for Applied Cognitive Psychology. Appl Cogn Psychol
2011;25:432–42.
5. Starkes JL, Ericsson KA. Expert Performance in
Sports: Advances in Research on Sport Expertise. Cham-
paign, IL: Human Kinetics; 2003.
6. Uchida Y, Kudoh D, Higuchi T, et al. Dynamic Visual
Acuity in Baseball Players Is Due to Superior Tracking
Abilities. Med Sci Sports Exerc 2013;45:319–25.
7. Laby DM, Rosenbaum AL, Kirschen DG, et al. The Vi-
sual Function of Professional Baseball Players. Am J
Ophthalmol 1996;122:476–85.
8. Hoffman LG, Polan G, Powell J. The Relationship of
Contrast Sensitivity Functions to Sports Vision. J Am
Optom Assoc 1984;55:747–52.
9. Vickers JN, Adolphe R. Gaze Behavior during a
Ball Tracking and Aiming Skill. Int J Sports Vis 1997;4:
18–27.
10. Mann DT, Williams AM, Ward P, et al. Perceptual-
cognitive Expertise in Sport: A Meta-analysis. J Sport
Exerc Psychol 2007;29:457–78.
11. Voss MW, Kramer AF, Basak C, et al. Are Expert Ath-
letes Expert in the Cognitive Laboratory? A Meta-analytic
Review of Cognition and Sport Expertise. Appl Cogn
Psychol 2010;24:812–26.
12. Mangine GT, Hoffman JR, Wells AJ, et al. Visual
Tracking Speed Is Related to Basketball-specific Mea-
sures of Performance in NBA Players. J Strength Cond
Res 2014;28:2406–14.
13. Reichow AW, Garchow KE, Baird RY. Do Scores on a
Tachistoscope Test Correlate with Baseball Batting Av-
erages? Eye Contact Lens 2011;37:123–6.

www.optvissci.com Optom Vis Sci 2021; Vol 98(7) 730

Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.


14. Laby DM, Kirschen DG, Govindarajulu U, et al. The
Effect of Visual Function on the Batting Performance of
Professional Baseball Players. Sci Rep 2019;9:16847.
15. Causer J, Bennett SJ, Holmes PS, et al. Quiet Eye
Duration and Gun Motion in Elite Shotgun Shooting.
Med Sci Sports Exerc 2010;42:1599–608.
16. Liu SC, Edmunds FR, Burris K, et al. Visual and Oc-
ulomotor Abilities Predict Professional Baseball Batting
Performance. Int J Perf Anal Sport 2020;20:683–700.
17. Burris K, Vittetoe K, Ramger B, et al. Sensorimotor
Abilities Predict On-field Performance in Professional
Baseball. Sci Rep 2018;8:116.
18. Poltavski D, Biberdorff D. The Role of Visual Perception
Measures Used in Sports Vision Programmes in Predicting
Actual Game Performance in Division I Collegiate Hockey
Players. J Sports Sci 2015;33:597–608.
19. Laby DM, Kirschen DG, Govindarajulu U, et al. The
Hand-eye Coordination of Professional Baseball Players:
The Relationship to Batting. Optom Vis Sci 2018;95:
557–67.
20. Harpham JA, Mihalik JP, Littleton AC, et al. The Ef-
fect of Visual and Sensory Performance on Head Impact
Biomechanics in College Football Players. Ann Biomed
Eng 2014;42:1–10.
21. Erickson GB. Sports Vision: Vision Care for the En-
hancement of Sports Performance. Philadelphia, PA:
Butterworth-Heinemann; 2007.
22. Abernethy B, Wood JM. Do Generalized Visual Train-
ing Programmes for Sport Really Work? An Experimental
Investigation. J Sports Sci 2001;19:203–22.
23. Page J, Causer J, Wilson M, et al. The BASES Expert
Statement on the Effectiveness of Vision Training
Programmes. Sports Exerc Sci 2013;12–3.
24. Appelbaum LG, Erickson G. Sports Vision Training:
A Review of the State-of-the-art in Digital Training Tech-
niques. Int Rev Sport Exerc Psychol 2018;11:160–89.
25. Appelbaum LG, Cain MS, Schroeder JE, et al. Strobo-
scopic Visual Training Improves Information Encoding in
Short-term Memory. Atten Percept Psychophys 2012;
74:1681–91.
26. Appelbaum LG, Lu Y, Khanna R, et al. The Effects of
Sports Vision Training on Sensorimotor Abilities in Colle-
giate Softball Athletes. Athl Train Sports Health Care
2016;8:154–63.
27. Appelbaum LG, Schroeder JE, Cain MS, et al. Im-
proved Visual Cognition through Stroboscopic Training.
Front Psychol 2011;2:276.
28. Akbas A, Marszalek W, Kamieniarz A, et al. Applica-
tion of Virtual Reality in Competitive Athletes—A Re-
view. J Hum Kinet 2019;69:5–16.
29. Michalski SC, Szpak A, Loetscher T. Using Virtual
Environments to Improve Real-world Motor Skills in
www.optvissci.com
View publication stats Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.
Sports: A Systematic Review. Front Psychol 2019;
10:2159.
30. Hadlow SM, Panchuk D, Mann DL, et al. Modified
Perceptual Training in Sport: A New Classification
Framework. J Sci Med Sport 2018;21:950–8.
31. Patten ML, Newhart M. Understanding Research
Methods: An Overview of the Essentials. New York, NY:
Routledge; 2017.
32. Maxwell SE, Lau MY, Howard GS. Is Psychology
Suffering from a Replication Crisis? What Does “Fail-
ure to Replicate” Really Mean? Am Psychol 2015;
70:487–98.
33. American Optometric Association (AOA). Sports Vi-
sion Section Bibliographic Resource. St. Louis, MO:
American Optometric Association; 2011.
34. Williams AM, Ford PR. Expertise and Expert Perfor-
mance in Sport. Int Rev Sport Exerc Psychol 2008;1:
4–18.
35. Laby DM, Kirschen DG, Rosenbaum AL, et al. The
Effect of Ocular Dominance on the Performance of Pro-
fessional Baseball Players. Ophthalmology 1998;105:
864–6.
36. Molia LM, Rubin SE, Kohn N. Assessment of Stere-
opsis in College Baseball Pitchers and Batters. J AAPOS
1998;2:86–90.
37. Müller S, Fadde PJ. The Relationship between Vi-
sual Anticipation and Baseball Batting Game Statistics.
J Appl Sport Psychol 2016;28:49–61.
38. Erickson GB, Citek K, Cove M, et al. Reliability of a
Computer-based System for Measuring Visual Perfor-
mance Skills. Optometry 2011;82:528–42.
39. Wang L, Krasich K, Bel-Bahar T, et al. Mapping the
Structure of Perceptual and Visual-motor Abilities in
Healthy Young Adults. Acta Psychol (Amst) 2015;157:
74–84.
40. Krasich K, Ramger B, Holton L, et al. Sensorimotor
Learning in a Computerized Athletic Training Battery.
J Mot Behav 2016;48:401–12.
41. Berg WP, Killian SM. Size of the Visual Field in Col-
legiate Fast-pitch Softball Players and Nonathletes. Per-
cept Motor Skills 1995;81:1307–12.
42. Lebeau JC, Liu S, Sáenz-Moncaleano C, et al. Quiet
Eye and Performance in Sport: A Meta-analysis. J Sport
Exerc Psychol 2016;38:441–57.
43. Vickers JN, Causer J, Vanhooren D. The Role of Quiet
Eye Timing and Location in the Basketball Three-point
Shot: A New Research Paradigm. Front Psychol 2019;
10:2424.
44. Fadde PJ. Interactive Video Training of Perceptual
Decision-making in the Sport of Baseball. Tech Inst
Cogn Learn 2006;4:237–56.
Optom Vis Sci 2021; Vol 98(7)
Vision and On-field Performance — Laby and Appelbaum
45. Clark JF, Ellis JK, Bench J, et al. High-performance
Vision Training Improves Batting Statistics for Uni-
versity of Cincinnati Baseball Players. PLoS One 2012;
7:e29109.
46. Deveau J, Ozer DJ, Seitz AR. Improved Vision and
On-field Performance in Baseball through Perceptual
Learning. Curr Biol 2014;24:R146–7.
47. Belling P, Ward P. Time to Start Training: A Review
of Cognitive Research in Sport and Bridging the Gap
from Academia to the Field. Procedia Manufac 2015;
1219–24.
48. Fadde PJ. Instructional Design for Accelerated
Macrocognitive Expertise in the Baseball Workplace.
Front Psychol 2016;7:292.
49. Gray R. Transfer of Training from Virtual to Real
Baseball Batting. Front Psychol 2017;8:2183.
50. Liu S, Ferris L, Hilbig S, et al. Dynamic Vision Training
Transfers Positively to Batting Performance among Colle-
giate Baseball Batters. Psychol Sports Exerc 2020;51.
51. Balasaheb T, Maman P, JS S. The Impact of Visual
Skills Training on Batting Performance in Cricketers.
Serb J Sports Sci 2008;2:17–23.
52. Hopwood M, Mann D, Farrow D, et al. Does
Visual-perceptual Training Augment the Fielding Perfor-
mance of Skilled Cricketers? Int J Sports Sci 2011;6:
523–35.
53. Revien L, Gabour M. Sports Vision: Dr Revien's Vi-
sion Training Exercises for Athletes. New York, NY:
New York Publishing; 1981.
54. Vine SJ, Moore LJ, Wilson MR. Quiet Eye Training
Facilitates Competitive Putting Performance in Elite
Golfers. Front Psychol 2011;2:8.
55. Ryu D, Abernethy B, Park SH, et al. The Perception
of Deceptive Information Can Be Enhanced by Training
That Removes Superficial Visual Information. Front
Psychol 2018;9:1132.
56. Romeas T, Guldner A, Faubert J. 3DMultiple Ob-
ject Tracking Task Performance Improves Passing
DecisionMaking Accuracy in Soccer Players. Psychol Sport
Exerc 2016;1–37.
57. Mitroff SR, Friesen P, Bennett D, et al. Enhancing
Ice Hockey Skills through Stroboscopic Visual Training.
A Pilot Study. Athl Train Sports Health Care 2013;5:
261–4.
58. Jenerou A, Morgan B, Buckingham RS. A Vision
Training Program's Impact on Ice Hockey Performance.
Optom Vis Perform 2015;3:139–49.
59. Formenti D, Duca M, Trecroci A, et al. Perceptual Vi-
sion Training in Non–sport-specific Context: Effect on
Performance Skills and Cognition in Young Females.
Sci Rep 2019;9:18671.
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