“I couldn’t beat people with my strength; I don’t have a hard shot; I’m not the quickest skater in the league. My eyes and my mind have to do the most work.”

— Wayne Gretzky

I’ve been immersed in the world of sport technology for the past couple of weeks and have had some really interesting conversations about how technology can help (or in some cases hinder) sport performance. One aspect that I’m always drawn to is the potential benefits of using technology to improve an athletes perceptual and cognitive skills.

While most training programs tend to focus on an athlete’s physical characteristics, there has always been at least a passing interest in the “mental” skills that underpin performance. I use quotations because I’m not talking about psychological skills like imagery, goal setting, etc. but referring to the skills that help athletes see the right information and make good decisions. For an example of what can happen when these skills go wrong, have a look at the video below!

In this week’s article, I’ll take a look at how perceptual and cognitive (PC) skills can influence performance and questions that coaches and teams should consider before adopting any type of training tool.

What are PC skills and why do we want to train them?

As I mention above, perceptual and cognitive skills can be thought of as mental skills. Except rather than training psychological skills they focus on how athletes perceive and use sensory information from the competition environment to support their performance. PC skills range from skills that are almost purely perceptual, such as basic visual skills or how athletes control their eyes while performing, to more complex perceptual-cognitive skills like anticipation and decision-making. Now, if we want to get really granular, we could argue that things like visual skills training aren’t perceptual-cognitive skills because they lack the cognitive component but in this article I’m going to refer to everything as PC skills to keep things simple!

Why are we interested in PC skills? You can probably think of any sport and name a player who isn’t the most physically gifted but has excelled because they possess the ability ‘see’ the game better than anyone else – guys like Wayne Gretzky and Lionel Messi come to mind. PC skills are the unseen skills that allow these players to dominate the game. Think about it, at the highest levels of sport, physical skills tend to be less of a limitation for athletes so we need to look at other areas to explain the incredible advantage some athletes have. And before anyone freaks out and says “well physical skills are important too”, absolutely. It’s the combination of a wide range of capabilities that contribute to expertise but, I’d argue, that aspects like PC skills are what sets the best of the best apart.

Key questions to ask yourself

The  Modified Perceptual Training Framework (MPTF) is a scientific approach to evaluating PC training tools and is designed to be fairly easy to use but, if that’s not your cup of tea, there are pretty straightforward questions you can ask yourself when considering adopting a training tool.

Does it look like the game? Remember concepts like specificity and representative learning design suggest that better transfer occurs when the information presented and actions required are closer to game-like. Is it targeting skills that are important for your sport? Again, think sport-specific here.

Is the tool training skills that would actually be used in competition. Beware of tools that target really generic skills – you’re more likely to be disappointed by the results.

Has the developer got any support to show that it works? Don’t take their word for it, look for anecdotes, case studies, or better yet experimental evidence. They’re trying to make money at the end of day and the best way to sell a product is to show that it works. It’s in both of your interests


Derek Panchuk is the founder of Chiron Performance and a Skill Acquisition Specialist with over 15 years experience working with elite athletes. Derek completed his postgraduate studies with Prof Joan Vickers at the University of Calgary where he studied gaze behaviour and Quiet Eye of elite hockey goalies. From 2014-2018 he was the National Lead in Skill Acquisition at the Australian Institute of Sport.


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The technology to measure and improve an athlete’s visual perception and on-field performance has never been better. But how you utilize that technology is key. There is an art as well as a science to it.

Performance vision testing on SENAPTEC sensory station

Helping athletes to see and perform better is what you might call our family business. My late father, Bill Harrison, OD, worked with countless professional athletes for over 45 years, in particular major league baseball players. He created “SlowTheGameDown” as a leading resource and training center to help professional, amateur and student-athletes of all sports. For the last 20 years, I joined my father in training elite and amateur athletes. We recently opened an elite training center in Irvine, Ca.  My background was as a Division II placekicker, and I have a degree in Exercise Physiology. My sister, Alicia, Harrison, OD, followed in the medical direction as an optometrist and also runs a sports vision practice in Laguna Beach, Ca.

Common in all our work is that we take a multifaceted approach to how the eyes play a role in sports. We examine the visual demands from a medical, skills and tactical approach and come up with treatments and training regimen for elite athletes to perform at a higher level.

Another common thread: Each athlete is different, and a successful training plan must be individualized in its goals and processes. We provide the human element of coaching, involving the entire life of the athlete, and not just machine testing and analyzing two eyes.

Establish a Baseline Evaluation

Let’s take the case of hitting a baseball, sometimes referred to as the hardest task in sports. In working with a hitter, we establish a baseline in four areas:

  • Clarity and quality of vision
  • Depth perception, eye tracking and visual processing
  • Visual Tactics: Are the eyes in the right place at the right time?
  • Concentration: Is an athlete thinking about other things?

Our baselines may differ from what a sports vision practice might commonly see, but creating an effective program still requires the same process. Always consider the athlete’s needs, challenges, fears, goals and lifestyle routines when developing a comprehensive neurodynamic vision program.

Visual Tactics and Concentration Patterns

The difference comes when we create a dynamic training environment to simulate the stress of an action-packed situation. Then we see differences and begin to identify challenges:

  • Are the eyes where they’re supposed to be?
  • Is the athlete sorting out good information from negative information?

Here we often discover an element less quantifiable but vitally important: The ability to notice clues and track patterns. It’s a conundrum of sports: If a catcher calls pitches all game long, why isn’t the catcher the best hitter on the team? It figures that they would know what pitch is coming from the opposing pitcher.

One answer is that a catcher can develop visual laziness. They have seen so many pitches that their visual intent becomes less intent. This can detract from their concentration and ability to recognize and anticipate patterns.

Consider: The first time that you drive an unfamiliar route, you work hard to recognize landmarks. After you drive that route regularly, you tend not to.

Similarly, a catcher has caught pitches so many times in a row, they can lose that same keen emphasis. Fatigue sets in, their focus shifts. The hockey goalie faces a similar challenge to be “in the zone” when the game seems to slow down. Here we may see two goalies with equally outstanding eyesight, but one can handle and process a lot of visual information while another is paralyzed with information. Some are better pattern recognizers than others.

Centering vs. Concentration

Most people talk about the importance of concentration–but concentration is not a good word in this case. Awareness of it doesn’t tell you anything about what to do. Most people try to concentrate by trying harder or by blocking things out.

It’s ironic that when we have our best concentration, we not even aware of concentrating.

Centering is an active effort of directing your energy to a target to process relevant, available information. It isn’t about aiming. It isn’t about blocking things out. Centering is about actively processing the available and relevant information radiating from your task at hand. It’s proactive in that you can direct and control.

Great concentration is relatively effortless and is not exhausting. Concentration appears to be something you’re conscious of only when you don’t have it, because when you’re concentrating, it appears to happen automatically.

Customize an Individual Training Program

It is important to work on developing an athlete’s strengths and negate their weaknesses without prejudging overall performance potential. We believe that data is only part of the evaluation process and must be shared with the athlete to help understand the development process.

It’s important to choose technologies that are validated for accurate measurements and a comprehensive database. These results should be cross-referenced against the trainer’s experience and expertise with the athlete and visual requirements of the sport during a 1:1 baseline evaluation.

The Shortcomings of Predictive Performance Models

One fast-growing area in major league baseball, as well as in other professional sports, is in testing skills and creating predictive models of potential performance on the field. This commonly involves testing individually and in the Combine that precedes drafts.

Testing and modeling is useful, but you need also to spend time with an athlete to fully understand their potential. Some athletes test well in a pre-draft Combine but their on-field performance fails to match up. Some have phenomenal vision but lack visual discipline.

One useful application of testing and modeling comes into play more in the middle of draft picks. When teams select their top draft picks, they expect phenomenal performance from the athlete right from the start. It’s the middle and lower picks, where teams want data and improvement models for players with potential, that they are willing to develop. By first dealing with these issues and addressing others, we may not help your very best players. But we will help your larger potential pool, and that wins games.

In addition to professionals, we work with a large number of college and high school teams. It is important to understand that you will find more fundamental visual problems that need to be addressed before performance vision training can be implemented.

  • Do athletes have correct Rx and eyewear, including contact lenses?
  • Are they wearing correct protective eyewear and sports specific tints?
  • Is there a significant difference between day time and night vision (under floodlights)?
  • Do athletes have comprehensive concussion baseline results to compare against?


NDV Performance Center
Irvine, Calif.

Training Center:  Great Park Ice and 5 Point Arena: 280,000-square-foot complex offers a variety of ice sports including youth and adult hockey programs, tournaments, figure skating, curling, broomball, sled hockey, public open skating, The Center will be used as the practice facility for the Anaheim Ducks NHL team.

Specialties:  Performance Vision training, athlete and team performance evaluations, concussion baseline assessment and rehab programming


is the founder of Slow the Game Down and the Director of Training for Neurodynamic Vision. He has a degree in Exercise Physiology from the University of California at Davis. Ryan has worked with his father, Bill Harrison, OD, on improving athletes’ visual performance on the field since 1999. Through the years, he has worked hundreds of baseball stars and organizations. He is currently working with the 2010, 2012 and 2014 World Champions San Francisco Giants. He previously has worked with the Toronto Blue Jays 2011-2015 and Philadelphia Phillies 2009-2012, as well as nine other professional baseball organizations over the last 14 years. At the college level, he has worked with the 2016 NCAA Champions Coastal Carolina, the 2012 NCAA Champions Arizona Wildcats, the 2013 NCAA Champions UCLA Bruins, as well as Oregon State, Wichita State, Kentucky, and Long Beach State. Ryan has worked with many collegiate softball programs, and with individual athletes in various sports such as MMA, Motocross, NHL, NFL, WTA, AVP, and PGA.


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As our worlds become more digital and visually demanding, we are leaving the era when visual acuity is the defining standard of good vision. We are entering an era where performance vision is a new standard of that measurement and where ECPs are well positioned to be the gatekeepers to both visual performance and overall eye health.

Technology provides us with the means to view vision and eye health within the entirety of human physiology. And by taking a holistic approach, we can improve lives by providing personalized and performance-enhancing vision solutions based on access to a multitude of biometric data.

I come to this conclusion based on more than a decade of clinical and research experience. As an ophthalmology-trained neuro-ophthalmologist, I measure visual functions by studying psychometrics, and I also have been involved in developing applications of AI, wearables and human-machine interfaces toward enhancing performance vision.

In my experience, I have observed a gap in how we understand and integrate the human visual system with overall physiology. From a traditional clinical approach, I repeatedly saw cases where a patient was examined and found normal, yet they had unresolved visual issues. A full range of biometric measurements were taken but not applied fully nor effectively to solve a visual problem or enhance visual performance.

As ECPs, we face a series of essential questions: How do we contextualize the biometric data we collect? How do we make this data meaningful and actionable? And how do we set and achieve goals for improvements in visual performance, for a variety of patients?

In our case, our patients include both elite and amateur athletes involved in competition or training to meet a personal best. We also see students immersed in study and professionals who are overworked and visually stressed, as well as patients who are rehabilitating a visual deficit from a concussion or other injury.

The task of addressing these kinds of varied conditions, needs and goals is at the heart of an emerging area we call performance vision. It is based on collecting and applying visual psychometrics, but it also involves the human element that we derive by evaluating the patient in their daily life environment.

We work with patients in a series of steps that begin with establishing a holistic baseline, then we employ intervention devices and measure and adjust at every stage of our process.


Establish a Baseline

This focuses on visual function, visual physiology and ocular structure, with a mix of new technologies and old-safeguard devices the average ECP is familiar with. For visual function, we democratized visual psychometric measurements typically done in vision science labs, and we apply these measurement techniques in software applications, including games.

Our process includes what we call the Vision Performance Index (VPI), comprised of over 103 psychometric signals, captured in the context of playing games. Current technologies we use also focus on visual function, electrophysiology, and structure.

Assign Intervention Devices

Once we establish a baseline, we prescribe interventions that incorporate devices and processes. These may include well-known devices and systems from Senaptec, Neurotracker, RightEye, Reflexsion, A-Champs, SyncThink, and others. We often employ multiple devices to address a number of conditions.


Measure Post-Treatment

The same biometrics measured in establishing the baseline are recorded and tracked throughout treatment. Whether we are looking to improve sports performance or rehabilitate visual performance and processing following an injury, detailed measurements allow us to objectively track progress. I always am struck with how individualized results can be. We continually measure the effect of treatment, to determine if it has been effective or if another course is warranted.

We Are All Athletes

We often talk about sports-performance vision as a rarefied field. The fact is, we all are athletes in many ways. We compete in work, sports and social interactions. The visual information we process and how well we process it can make fundamental differences in all aspects of our lives.

I work with elite athletes, including teams of esports athletes—gamers—who are challenged to process an overload of visual information and make good decisions instantaneously, all in a high-stress, artificial digital environment. Micro-increments of improved processing can make a huge difference in this world. But the same is true in our everyday lives.

Improvements in visual intake and processing of visual information are sought after by weekend warriors looking for an edge in their tennis or golf game or by an under performing student looking to reduce the eye strain brought on by sitting in front of a computer monitor. Likewise, enhanced visual performance is critical for a surgeon peering through a scope and conducting robotic surgery. The recovery from a concussion can be accelerated with the care of an ECP. And we can help a beleaguered accountant get through tax season by reducing eye strain.

At the same time, how well we can read and process visual information can mean life or death.

Picture a police officer engaging a suspect in a dimly lit street confrontation, or a fireman skirting flames and calculating the compromised stability of the floor he is walking on. Still further, imagine a combat soldier in a firefight where her vision is obscured but augmented by data displayed on her goggles.

For all of these visual needs, the collection and analysis of clean biometric data–collected in a standardized and consistent manner—is the key to providing improved vision and eye health services. And in that regard, all ECPs can participate. To achieve this, we don’t need to change much of anything, except how we think about eyecare.

We hope that we are helping to equip the next generation of ECPs to help patients to achieve the highest level of visual performance and improve their lives.


Performance Vision Meets Varied Needs

The implications of a holistic process are not limited to elite athletes or even to sports. Virtually everyone can be helped. A treatment to deliver a competitive edge might be as simple as prescribing better, more personalized eyeglass lenses. Or it could include a regimen of performance enhancing exercises. Employed in a holistic way, biometric measurements have applications in meeting a variety of patient needs:

Sports vision performance:  Professional, amateur and student-athletes all want to improve competitive skills or achieve a personal best.

Rehabilitative care: Those suffering concussions or injuries need help in relearning how they see and how they process visual information.

Low vision and partially sighted: New technology provides vast opportunities here, and the neurological component is a factor in success.

Military, firemen, police: The inherent dangers of high-risk occupations can be mitigated with biometric baseline measures and exercises to up-regulate and down-regulate select visual information.

Khizer Khaderi, MD, MPH


is Adjunct Clinical Associate Professor at the Byers Eye Institute and is founder of Stanford’s Performance Vision Center. He also is founder and CEO of Vizzario, a human-centered AI platform where neuroscience is combined with artificial intelligence to deliver the next generation of intuitive AI.


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Sports vision is often referred to as a specialty within optometry, but I see it differently: as a core optometric service that can be part of most every optometric practice. In fact, what we now call “sports performance vision and dynamic vision testing” is fundamental to our optometric calling, which is to enhance the visual performance and lives of our patients.

It has been my privilege to serve as team optometrist to the Washington Redskins, Wizards, Mystics and DC United, as well the Director of Visual Performance for the Washington Nationals. But in our practice, which has five locations in the Virginia-D.C. metro area, we also help young athletes and their families to improve their visual performance every day.

Technology advances are dramatically enhancing our ability to establish visual performance baselines and then to track improvements in an objective data-based process. But we bring basic optometric skills to this process, as well. When I speak to optometry students, I explain that they will enter practice with most of the knowledge and many of the skills to do most of what we provide in neurodynamic vision services or what we call sensory-cognitive sports vision training. At the same time, I alert students to the fact that athletic trainers and physical therapists are beginning to conduct visual performance evaluations and training. Shame on us if we miss this opportunity or hand it off to others. ODs need to carve out our place at the table while we still have it.

Today, when a parent calls an OD and says. “My child suffered a concussion on the playing field and was  told to see a vision rehabilitation specialist,” most ODs would say they cannot provide that. I want us to get to a place where most ODs will say, “We can provide that; let’s schedule an appointment!”

Seek Out Training & Expertise

Specializing in sports and performance vision is something that works only if you love sports. There are profits to be made, but you have to love working with athletes and teams because it often demands time away from family and practice.

When I graduated PCO Salus University nearly 20 years ago, I was focused on sports vision and vision training and sought out experts among the optometric community in my area and nearby. There were a few courses available, but I learned because I sought out the best and studied what they did.

At the time, “vision training” had a bad name since some medical professionals felt it lacked science. Also, “sports vision” had been around, and many perceived this as working with pros, not so much with kids and amateur athletes.

I became involved with the AOA Sports Vision Committee, and we changed the name–for strategic  purposes–to Sports & Performance Vision. Again, we wanted to broaden the appeal to include not just ODs who were “sports specialists” but all ODs who had an interest in adding such services to a general practice.


Diagnostic Instruments:

Auto-Refractor, Visual Fields, OCT, Optomap, Portable Tonometer

Vision Training Equipment (essential & optional):

Big screen display screen, RightEye system, NeuroTrainer, Senaptic or Vima strobe glasses

Facility & Space:

Pre-test area, Exam room, Sports room, 500 square feet

Be Part of Sports Training Community

Over the past two decades, I have had the privilege of working with a number of professional sports teams, and I’ve seen a dramatic change in the medical expertise that teams now seek.

Once, there was a team doctor. Now a pro team may have a podiatrist, a physical therapist, a chiropractor, a dentist, a neurologist, an orthopedist–as well as an optometrist–on board. There are times when medical professionals outnumber players in the locker room.

This is an enormous opportunity for optometrists. We have great chances to learn from and network with an array of other medical professionals–and we can raise the level of understanding about what optometry brings to the table. Again, we need to claim our place at the table — and be part of the “performance team” of both professional athletes and amateur and youth athletes we work with.

Equipment &Technology

Another enormous change in recent years comes from advances in diagnostic and training technology. In particular, we can employ diagnostic equipment to create baselines in visual performance-eye tracking, dynamic visual focus, visual concentration, visual pursuit, binocularity, reaction times, etc.

This data is important for a number of reasons. It establishes a baseline that determines natural ability, and against which we can track improvement. RightEye, for example, analyzes data to generate what it calls a “Sports Vision EyeQ.”

Should an athlete be injured, and here concussion is a common and debilitating injury, a sports performance baseline provides a critical evaluation tool and a measuring stick in rehabilitation. Further, the ever-higher level of data on visual performance can be used to predict likelihood of injury and to extrapolate maximum performance. In professional sports, data is king, and sports organizations are adding statisticians and analysts from top schools like MIT who play critical roles in determining which athletes get top contracts.

Immediate ROI

Establishing a sports and performance vision specialty requires some instruments, equipment, space and time, but the investment need not be a daunting one. In our practice, it required adding the equivalent of only one more autorefactor and a visual field. In 10 years time, we have invested perhaps $50,000 in equipment related to sports vision training, and we saw that investment paid back in one year. In other words, we’ve been in the black for nine of the last ten years that we have incorporated a sports and performance vision component to our practice.. In other words, we’ve been in the black for nine-and-a-half of the 10 years we’ve specialized in neurodynamic vision.

But again, we do this for love of sport. And the rewards have been tremendous. We’ve helped teams on their way to achieving championships, we helped athletes back from injuries, and we’ve helped pros and kids alike to achieve dramatic and measurable improvements in playing the sports that they love.


NEURODYNAMICVISION.org is your single source for the latest information in the understanding of the power of the brain to improve overall human performance. Any new sub-specialty requires a combination of interrelated activities that help elevate an idea from obscure theory to everyday practice. NEURODYNAMICVISION.org offers these in the form of the latest information in the areas of validated scientific research; proprietary testing protocols supported by new advanced concepts in
sports-vision-related tools and training products, and consumer education, awareness and understanding of the benefits of improved performance, both on and off the field.


practices at Northern Virginia Doctors of Optometry, which has locations in Alexandria, Arlington, Falls Church and
Reston, Virginia. Dr. Smithson works with amateur and professional athletes to enhance visual performance for sports and to remediate
the visual symptoms of concussion. He is the immediate past chair of the American Optometric Association’s Sports and Performance
Vision Committee and member of the AOA’s TBI Task Force. He is the Director of Visual Performance for the Washington Nationals, the
Team Optometrist for the Washington Redskins, Wizards, Mystics, Spirit and DC United, as well as a visual performance consultant for the
Washington Capitals. He also is sports vision consultant for several companies. Contact: ksmithson@sportsvisionpros.com


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