Football vs. Eyeball
Authors: Toby Anne Penington, Low Vision Coordinator at the Criss Cole Rehabilitation Center, Austin, TX and Charlotte Simpson, Region 3 Orientation & Mobility Specialist for Central Texas
Keywords: eyeball, football, retina, photoreceptors, rods, cones, tunnel vision, blurry, retinitis pigmentosa, alternate skills
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How WELL We See vs. How MUCH We See
In football, the goal is to advance the ball forward to reach the end zone in the back of the field to get points. The same is true for the eyeball. Light enters the eye and must advance forward to reach the “end zone” (the retina) in the back of the eye to get vision.
The retina is a thin layer of nerve cells that lines the back wall of the eye. Its job is to receive the light and then convert it into signals. In football, if the ball is prevented from reaching the end zone, there are no points. In the eyeball, if the light is prevented from reaching the retina, there is no vision.
In football, the team is comprised of individual players. Each player has a specific job to do to be successful. The players are divided into two different groups: the offense and the defense. The eyeball works in a similar fashion. Instead of individual players, the retina is comprised of individual cells called photoreceptors. Each photoreceptor cell has a job to do to get vision.
Similar to the football team’s offensive and defensive groups, the photoreceptor cells are divided into two groups as well: cones and rods. The cone cells are responsible for our acuity vision—our color, clarity, and central vision. In other words, they determine how WELL we see. The rod cells are responsible for our visual field—our night vision and peripheral vision. This is how MUCH we see.
Just like in football, the two groups are not really interchangeable. For example, a linebacker from the defense cannot do the job of a quarterback from the offense. The same is true for the eyeball. A cone cell cannot do the job of a rod cell, and a rod cell cannot do the job of a cone cell. Whether you are learning about football or the eyeball, understanding who the individuals are and how they function is the first step in developing a plan for success.
Luis was a young student who had a retinal eye disease that affected his rod cells but not his cone cells. He had good acuity but a poor visual field. In other words, he could see WELL but not MUCH. This type of vision loss is often called tunnel vision. He could see directly in front of him but nothing on the sides. For him, it was as if he was viewing the world through a paper towel roll. This led to many misunderstandings and mishaps. Friends in the school hallways would wave “hello” to him, but he would not see them to respond. He would bump into, step on, and trip over obstacles or objects, making him appear to be clumsy, distracted, or aloof. Luis was struggling in school, but his eye condition was not diagnosed until later in life because he could see WELL.
Fractions vs. Functions
In football, if a team’s offense is functioning well but the defense is not, winning the game becomes difficult. In the eyeball, if the cone cells are functioning well but the rod cells are not (or vice versa), daily activities become more difficult.
Luis’ eye disease went undiagnosed until after he graduated from high school because he still had good fraction vision. He had 20/20 acuity and did not require prescription glasses! He could read his textbooks, mobile phone, and any small print without magnification or devices. Although his fraction vision was good, Luis struggled with functional activities. He was fired from his job as a busboy at a restaurant for poor performance. He broke his foot after falling off a patio deck due to poor depth perception. He cut his face on a low hanging sign that he did not see while traveling on the sidewalk in the evening. His tunnel vision was impacting his life, but he was unaware of the reason.
In football, when a player commits an infraction, an official will throw a flag to stop the play and address the issue. In the eyeball, our eye doctors are the officials. When something is wrong with our vision, they will address the issue. For most people, a flag about their vision could mean that they are experiencing blurred vision or eye pain.
Luis had neither of these flags, so he never went to the eye doctor. He had no idea that the number of rod cells in his eyes were decreasing. He was slowly losing his night vision and his visual field was being reduced.
Low Vision, Low Batteries
Imagine you are playing in a football game, but your team only has a few players and no substitutes. The players would be exhausted by the middle of the game. How could they be expected to keep up or win in this situation? By the end of the game, they would feel completely drained. When you have an eye disease with fewer photoreceptor cells available to receive the light and then convert it into signals, the remaining cells have to compensate for the missing information. Eye fatigue and discomfort are common flags that are often missed.
Like many young men his age, Luis enjoyed playing video games with his friends for hours at a time. But unlike his friends, he experienced severe eye fatigue, headaches, and discomfort not long after starting. It was as if his vision “batteries” would drain faster than his friends. Luis needed to take frequent breaks, lay down or rub his eyes to “recharge”. He was so accustomed to experiencing severe eye fatigue and discomfort that it never occurred to him that this was an official flag about his vision.
After high school graduation, Luis’s family noticed that he began declining offers to meet up with friends and did not leave home as much. What they did not know was that Luis’ visual field was continuing to reduce. His tunnel vision declined from viewing the world through a paper towel roll to viewing the world through a soda straw.
Time Left on The Clock
There is a popular quote in sports that “if you think practice is boring, try sitting on the bench,” emphasizing the importance of hard work and training. I like to compare blindness training to football practice. In both, people must start off with the basics and work towards more advanced skills. They repeat tasks over and over until they are second nature, and they learn to analyze, problem-solve, and then change tactics when something is not working. Most importantly, practice is needed in order to be ready for all the challenges the game has to offer. I like to think of this as a metaphor for life.
Two years after graduating from high school, Luis was finally diagnosed with a progressive eye condition called retinitis pigmentosa. He was told that although he still had 20/20 vision, he was legally blind and encouraged to seek training for his visual impairment as he would likely continue to lose more vision. Luis arrived at the Criss Cole Rehabilitation Center in Austin, TX, convinced his life was over. He was only 20 years old.
With time, practice, and patience, Luis became proficient using alternative skills to accomplish the tasks that he always enjoyed. Just like any new training, there were fumbles and frustrations, but he no longer felt benched due to his vision loss. He went from being a spectator to being a participant again!!
Luis was fortunate. He had a large cheering section from his friends and family who celebrated every accomplishment, big or small. He had a bright future ahead which included attending college. Learning the skills to be successful took hard work, persistence, and determination…but that is okay, because it was all part of the game!!
Post-game Wrap Up
This article is a condensed version of a PowerPoint presentation of the same name and has been reformatted for TX SenseAbilities. If you would like to see this presentation or have any questions or comments, please contact the authors at: Toby.Penington@twc.texas.gov and Charlotte.Simpson@twc.texas.gov