The Pan-American Journal of Ophthalmology

: 2020  |  Volume : 2  |  Issue : 1  |  Page : 12-

Visual function of high-performance judokas

Patricia Gomes Silva1, Livia Cristina Rios1, Priscila Rodrigues Leite Oyama2, Caio Vinicius Saito Regatieri3, Bernardo Kaplan Moscovici3, Paulo Schor3, Breno Schor4,  
1 UPO – PAULISTA OPHTHALMOLOGY UNIT, UNIFESP – Federal University of São Paulo, São Paulo, Brazil
2 Department of Endocrinology, UNIFESP – Federal University of São Paulo, São Paulo, Brazil
3 Department of Ophthalmology, UNIFESP – Federal University of São Paulo, São Paulo, Brazil
4 Department of Orthopedics, UNIFESP – Federal University of São Paulo, São Paulo, Brazil

Correspondence Address:
Dr. Patricia Gomes Silva
UPO - Paulista Ophthalmology Unit


Descriptive case series of visual function of high performance judokas.

How to cite this article:
Silva PG, Rios LC, Oyama PR, Regatieri CV, Moscovici BK, Schor P, Schor B. Visual function of high-performance judokas.Pan Am J Ophthalmol 2020;2:12-12

How to cite this URL:
Silva PG, Rios LC, Oyama PR, Regatieri CV, Moscovici BK, Schor P, Schor B. Visual function of high-performance judokas. Pan Am J Ophthalmol [serial online] 2020 [cited 2020 Aug 8 ];2:12-12
Available from:

Full Text


The medical evaluation of high-performance athletes aims to identify the general and specific findings for each sport. Within sports medicine, there is sports ophthalmology, which aims to analyze the visual function and its impact on the performance of sports.[1] The visual function can be measured basically in two ways: quantitatively by visual acuity and qualitatively by aberrometry, through high-order aberrations in Root Mean Square (RMS).[2],[3],[4],[5],[6],[7],[8],[9],[10] There are many other tests that contribute to the assessment of visual function, such as visual field (which indicates whether the athlete has peripheral vision), Titmus test (which indicates whether there is binocular vision and a sense of depth), and spherical equivalent (equal to the algebraic sum of the value of the sphere + half of the patient's ametropia cylindrical value). Judo is a sport of physical contact and depends on the speed, reflexes, strength, and technique. The quality and quantity of vision can influence this sport. We also believe that peripheral vision and a sense of depth can influence the success of athletes, improving the ability of judokas.[2] The high spherical equivalent indicates that the athlete may have trouble achieving good vision without the use of glasses.[5],[7] This study aims to evaluate the visual function of the judo athletes and their impact on the athletes' performance.


It is a descriptive study in which judokas who agreed to participate in this work were included. The examinations were carried out by residents and technicians in a private eye clinic, sequentially, on the same day and place. Visual acuity with and without correction, refraction, Stereopsis, aberrometry, and visual field of 13 athletes were evaluated. All athletes, with the exception of one judoka, were men, aged 26.2 years (ranging from 22 to 34 years).

Visual acuity was measured using the Snellen table, with or without optical correction, in the same room, with a distance of 4 m. Patients who saw 20/30 or more were considered normal. The spherical equivalent was calculated, translating to the algebraic sum of the sphere value + half of the patient's ametropia cylindrical value.

Titmus Stereo Test (Stereo Optical Co., Inc., Chicago, IL, USA) was later used for the stereopsis examination. It is a test that consists of a two-sided book, with figures on each side that have been projected in duplicate. With the use of polarized glasses, the patient should see the figures in “relief” (three-dimensional). This perception is measured in seconds of arc (″), which can vary between 3000″ and 40″, the larger numbers being associated with a lesser sense of depth. Values below 100″ are considered normal. Wavefront analysis (aberrometry) was performed with Mydriasis, in the LADARVISION apparatus (Alcon, Texas), with 5 measurements taken by the same examiner. Altered RMS values were >0.5. The visual field test was performed using the Humphrey perimeter device (Zeiss, Germany) with the 750l strategy and the Anderson criteria (define objective damage for the diagnosis of glaucoma) to classify the field tests as normal or not.

We compared the results of the examinations with the athletes' position in the ranking, in order to establish or not causal relationships.


All visual field examinations were normal. The high-order aberrations were between 0.15 and 0.62, being altered only in one judoka with the diagnosis of keratoconus. Nine patients had Titmus of 40″ (maximum), two of 50″, and one of 60″. Only one patient obtained Titmus 200” (same patient with keratoconus). The athlete with keratoconus demonstrated impaired distance vision (20/60 in the right eye and 20/25 in the left eye), even with correction, and a spherical equivalent >4 diopters in the right eye. In addition to this judoka, only one other athlete had a spherical equivalent larger than a diopter (1.125), but had normal vision, because despite being nearsighted, he had a small pupil, and this myopia allows clear vision up to a meter away. The test results are shown in [Table 1].{Table 1}


Only the patient diagnosed with keratoconus showed abnormal values in the examinations, mainly in one eye, presenting a stereopsis value much above normal, which means that he may have problems in the sense of depth. All other patients had normal tests, and most of them had normal high-order aberration values. The most logical would be to correlate the visual function with the performance of these judokas, however, in this case series we did not found this correlation [Graph 1], [Graph 2], [Graph 3]. Garland et al revised the influence of the visual acuity, dynamical refraction and cognition differences (like memory for game situations and decision accuracy) and found that cognition was more related with better performances [11], since the high-order aberrations, the spherical equivalent, and the Titmus did not correlate with the position in the ranking [Graph 1], [Graph 2], [Graph 3]. Future investigations with larger samples and performance results may point to conditions that have a greater influence on sports practice, which was not possible with this research due to the lack of discriminatory tests or the lack of a representative sample. There is no similar research in the literature.[INLINE:1][INLINE:2][INLINE:3]

Financial support and sponsorship


Conflicts of interest

There are no conflict of interest.


1Raschka C, Rau R, Koch HJ. Influence of choking in Judo on vision in well-trained Judoka: an explorative field study. Nagoya J Med Sci 2003;66:31-8.
2Kaido M, Dogru M, Ishida R, Tsubota K. Concept of functional visual acuity and its applications. Cornea 2007;26:S29-35.
3Salmon TO, van de Pol C. Normal-eye Zernike coefficients and root-mean-square wavefront errors. J Cataract Refract Surg 2006;32:2064-74.
4Sponsel WE, Arango S, Trigo Y, Mensah J. Clinical classification of glaucomatous visual field loss by frequency doubling perimetry. Am J Ophthalmol 1998;125:830-6.
5American National Standards Institute. In: American National Standards for Ophthalmics-Methods for Reporting Optical Aberrations of Eyes. ANSI Z80.28; 2004.
6Applegate RA, Sarver EJ, Khemsara V. Are all aberrations equal? J Refract Surg 2002;18:S556-62.
7Applegate RA, Marsack JD, Ramos R, Sarver EJ. Interaction between aberrations to improve or reduce visual performance. J Cataract Refract Surg 2003;29:1487-95.
8Pepose JS, Applegate RA. Making sense out of wavefront sensing. Am J Ophthalmol 2005;139:335-43.
9Applegate RA. Glenn Fry award lecture 2002: Wavefront sensing, ideal corrections, and visual performance. Optom Vis Sci 2004;81:167-77.
10Marsack JD, Thibos LN, Applegate RA. Metrics of optical quality derived from wave aberrations predict visual performance. J Vis 2004;4:322-8.
11Garland DJ, Barry JR. Sport expertise: the cognitive advantage. Percept Mot Skills. 1990;70:1299-314.