All eyes on the GAME...

By Dean Temple
Tennis Magazine
July/August 2000

VISION PLAYS A SIGNIFICANT role in tennis, one we often take for granted. But our eyes are arguably our most valuable asset on the court. In the bigger picture, the eyes can reveal the first signs of illness elsewhere in the body. With a careful examination, a physician can detect early signs of diabetes and hypertension and even predict future risks of blindness, strokes, or heart attacks.

Unlike other muscles, you can't exercise your eyes to improve your focus. You do that mostly just by looking around, says Mark Speaker, M.D., Ph.D., of Laser and Corneal Surgery Associates in New York.

But you can and should protect your eyes. Robert Maloney, M.D., M.A., of the Maloney Vision Institute in Los Angeles, says that tennis players, particularly recreational players, should always wear some type of eye protection, be it sturdy-framed sunglasses or safety glasses. In contrast to a baseball, a tennis ball is compressible, so it can work its way past the eye socket and go directly into the eye. "We see some of the worst eye injuries this way," says Maloney. "Pros usually get their racquet up in time, but amateurs have a problem with this when they get tired at the end of a match."

And it's not just the tennis ball that imperils the eye. Excessive exposure to the sun's ultraviolet rays can have serious consequences. One of the worst is called pterygium.

Pterygia, which are similar to calluses, form on the surface of the eye. These triangular membranes tend to spread from the area around the tear duct outward, and in severe cases they can grow across the cornea and impede vision. Although it has a high recurrence rate among those who participate in outdoor sports like tennis, pterygium can be treated with basic surgery.

Protracted UV exposure can also cause cataracts and, in rare cases, melanoma on the surface of the eye. So find a pair of sunglasses with UV absorption (most that offer protection against UV are so labeled). And don't even think about wearing contacts with UV protection as a substitute. It's just as important to cover the sclera (the whites of your eyes) as it is to cover the iris and pupil.

Let's face it: Nobody likes to wear lenses of any kind during match play. Otherwise, we'd see the pros wearing sunglasses in every tournament. But sunglasses and traditional corrective measures can be more than just a pain; they can be a hindrance to your game. They can fall off and break, fog up, and even, at certain angles, distort your sight. Contacts cause drying, can shift uncomfortably, and become extremely painful when sun-block runs into the eyes.

Although you should always wear protective lenses, especially outdoors you can also improve your vision with the increasingly popular LASIK eye surgery.

With LASIK which stands for laser in situ keratomileusis surgery a surgeon uses a precisely calibrated cool beam of laser light to reshape the cornea providing the same clarity of vision that's achieved with prescriptive lenses. Today's lasers can remove as little as V4o of a human cell providing remarkable precision and predictability. The surgery is fast and painless and can eliminate the need for glasses altogether. Patients often return to work the next day.

Indeed one of Maloney's patients was on the golf course the day after her surgery-and scored her first-over hole in one. Coincidence? Most likely. But one can't help but wonder what effect her new-found vision had on her mental game.

"Gaining the competitive edge is the main reason most athletes have the procedure done says Speaker". "Tiger Woods' who was severely nearsighted had the procedure done and two weeks later he began his streak of tournament wins. Psychologically, the surgery does wonders for a player's confidence."

Richard Krajicek was in search of such a confidence boost when he sought out Speaker's LASIK expertise after last year's U.S. Open. Before the surgery, the 1996 Wimbledon champ. Recreational players should always wear some protection, be it sturdy-framed sunglasses or safety glasses found that the intense concentration he went through while waiting to receive serve was often hindered by a split-second blink or tearing from his contacts. "Now he can keep his eyes open for longer, with less irritation," says Speaker. "He's more focused on his game and has more of an edge."

Granted, the idea of someone taking a laser to your eye can be a daunting one, but according to Maloney, the biggest risk is that your vision may not be totally perfect. "It will be good enough for any daytime activity," he says, "but you may need glasses for night driving." In many cases, the patient's vision corrects to 20/20. Complications include dryness and seeing a halo around lights at night, which goes away after a few months.

According to Maloney, LASIK is ideal for cases of nearsightedness up to-10 diopters and for cases of farsightedness up to +5. With more severe vision impairments, the Artisan Lens, or implantable contact lens, is used. In this procedure, a permanent lens is floated in the fluid behind the cornea. Once implanted, the lens-made out of a plastic similar to the one in hard contacts-can't be felt by the patient.

There are other procedures: PRK, a laser process that treats moderate nearsightedness and astigmatism, and HLK, a nonlaser process for cases of moderate farsightedness and astigmatism. CK, a new technique, uses radio waves to reshape the eye and correct farsightedness.

All of these procedures can be pricey-as much as $2,500 per eye-but don't be fooled by bargains, says Speaker: "Most people wouldn't shop for a discount heart or brain surgeon, so don't take that chance with your eyes." And Maloney believes that within 20 years, the need for glasses and contact lenses will be eliminated. "Our grandchildren," he says, "will grow up not knowing what corrective lenses are." Things are indeed looking brighter for the tennis player of the new millennium.