Page 70 - Journal of Special Operations Medicine - Summer 2015

Depth perception (static and dynamic stereopsis; ver- to the face. Very important for reading. Near point of
gence function; spatial localization): includes speed and convergence is the most common oculomotor dysfunction
accuracy of judging two-eyed depth and distance infor- seen in TBI. This test is performed manually with a tool
mation, and, therefore, is actually two separate domains: provided in the Nike SPARQ package (www.nike.com).
stereopsis and speed of recognition. This should also
be considered a top-tier function necessary in nearly all The STS has software programming for training mod-
combat and field military specialties. Equipment avail- ules for split-attention/dual-task processing that trains
able to evaluate and train static depth perception: How- eye–hand coordination while the subject reads aloud a
ard-Dolman device. No equipment available for dynamic series of numbers, and a training module for eye–hand
depth perception. coordination, go/no-go, and depth perception. Also
available with the STS are low-technology, validated
Near–far quickness (accommodative function; vergence analog training devices and tools for oculomotor func-
function; visual acuity; oculomotor skills; fixation and tion, dynamic visual acuity, near–far quickness, saccadic
saccadic movements): quickly and clearly changing vi- and anticipation training, and convergence/divergence
sual attention between near and far distances; especially evaluation and training.
important for multiple-target engagements at varying
distances. Commercially available equipment includes The characteristics for evaluation are desirable for train-
Haynes distance rock test cards.
ing, as well. 75,77 Training programs should attempt to
Target capture (peripheral awareness; speed of recogni- show efficacy and improvement through relevant clini-
tion; saccadic eye movement; oculomotor function): dis- cal research. The visual skill improvement should be
crimination of information that is moving, and involves correlated to a concurrent improvement in performance,
rapid visual shift and recognition of a peripheral target. if possible. 71,72,78 Using the STS or future upgraded ver-
Commercially available equipment that evaluates pe- sions as a screening tool will also lay the groundwork
ripheral awareness: Peripheral Awareness Trainer (PAT) for further research that proposes to examine the effect
(Wayne Engineering; www.wayneengineering.com). of visual skills training on performance, as well as begin
to capture normative data for the SOF.
Perception span: short-term visual memory; ability to
recall detail from a quick snapshot.
Conclusion
Eye–hand coordination (visual-motor reaction time;
speed of recognition): speed and accuracy of visually A better understanding of visual-motor skills will help
guided hand responses to rapidly changing targets; abil- rehabilitation and performance specialists better for-
ity to make synchronized motor responses with the hands mulate how to incorporate visual screening and visual
to visual stimuli. Commercially available equipment that skills training into human optimization and perfor-
evaluate and train this domain include: the Wayne Sac- mance-based rehabilitation programs for SOF-qualified
cadic Fixator and the Multi-Operational Apparatus for Soldiers. Visual sensory stations are becoming popu-
Reaction Time (MOART) (both Lafayette Instrument lar in professional sports and the National Collegiate
Co.; www.lafayetteinstrument.com); the SVT (Sports Vi- Athletic Association Division I sports programs. There
sion; www.sportsvision.com.au); and Dynavision 2000 is as yet a small, but promising, amount of literature
and Dynavision D2 light boards (Dynavision Interna- to support their use, but there are several decades of
tional LLC; dynavisioninternational.com). literature to support the use of optometric evaluation
and visual skills training in a variety of sports and at
Go/no go (speed of recognition; rapid motor decision- locations such as the US Olympic Committee and US
making; visual-motor reaction time; eye–hand coordi- Air Force Academy facilities. 22,32,54,61,77,78,89,90,92,95,96 Sev-
nation): quick and accurate decision-making in pressure eral studies have demonstrated reliability and validity
situations. of the visual sensory station technology, as well as sen-
sitivity in detecting differences in performance related
Hand reaction time (visual motor reaction time; speed
of recognition; eye–hand coordination): quickness and to factors effecting psychomotor skills. There are also
speed of athlete’s hand. Other commercially available promising early data suggesting sensitivity in detecting
25,42,93
devices that evaluate and train this domain include: differences in concussed individuals. Given mean
Wayne Saccadic Fixator, Visual Choice Reaction Time age differences, unique mission sets and unit structure,
Apparatus, and the MOART system (all Lafayette In- psychological differences, and a rigorous vetting pro-
strument Co.; www.lafayetteinstrument.com). cess, there is a need for studies dedicated specifically to
the SOF. Since this population is the closest approxi-
97
Visual endurance (near point of convergence): near vi- mation to the tactical athlete paradigm, studies should
sion involving simultaneous bilateral (conjugate) inward be conducted exploring performance enhancement re-
movement of the eyes to maintain focus on objects close search. Derivations of common sports medicine and

60 Journal of Special Operations Medicine Volume 15, Edition 2/Summer 2015