Seeing Eye To Eye

What is Sports Vision Training?
Written By: | March 21, 2012

Pepose Provision sports vision training improves an athlete’s performance by training visual skills such as peripheral awareness, eye-hand coordination, and speed and span of recognition, all by using a scientifically proven system called the Sensory Motor Integration Technique. We train athletes to process greater amounts of visual information faster and more accurately so that they make better decisions, faster decisions, and their physical reactions are faster and more accurate, especially when under stress situations as found in sports.

The training program begins with an evaluation of the athlete’s current skill levels, in terms of their strengths and weaknesses, and is compared to a database of elite athletes that has been compiled since 1984. The evaluation is conducted over five sessions using the DynaVision board, Eye Span and the Vizual Edge systems. The individual training plan is designed based on the results of these evaluation sessions.

Just like weight and strength training, dynamic visual skills training requires consistency to sustain and build on peak performance.

Some Key Terms of Sports Vision:

Speed and Span of Recognition

How much information a player is able to take in at once and how quickly he is able to interpret it. An increase in an athlete’s speed in recognizing a visual stimulus results in a physical response that is much quicker and more accurate.

Eye-Hand Coordination

The eyes lead the body, not the other way around. The visual system leads the motor system. Our hands or feet or body respond to the information the eyes have sent to the brain. If this information is incorrect, even to the slightest degree, there is a good chance that we will make a mistake in our physical response. Almost every sport error, or poorly executed play, can be attributed to faulty visual judgment, and it is visual judgment alone that determines eye-hand coordination.

Peripheral Awareness

Peripheral awareness can be greatly enhanced by using retinal stimulation. Well developed peripheral awareness helps the athlete to see everything at once, to maintain the whole pattern or the flow of the play, even as they move within it.

Anticipation Timing

The ability to accurately perceive or anticipate what is about to happen, and when. Visual skills training improve your ability to selectively detect important advance physical cues. However, since timing is the key to effective performance, it’s important not to over anticipate and commit yourself too soon. Most efforts fail not because the physical movements were wrong, but because they were made at the wrong time, either too soon or too late. The ability to anticipate is a major factor in high level competitive activities, and even superior speed, size and reflexes cannot compensate for the insufficient processing of the visual information regarding when to perform.

Visual Reaction Time

The amount of time required to process the visual information and initiate a physical reaction/response.


The ability to maintain a high level of focus on a key target or objective, in spite of distractions, while also maintaining total awareness of what is happening around you.

Focusing and Tracking

Focusing flexibility and tracking are two separate skills, but inseparable as they must work together to achieve good, clear vision; for example, keeping your eyes on the ball. This requires both the ability to change focus instantaneously as objects move closer to or further away from you (accommodation), as well as the ability to keep both eyes working in unison as they track rapidly moving objects (convergence/divergence). Studies have shown that if the athlete’s head has to move to aid in eye tracking, his performance is not only less efficient, but balance may be thrown off also.

Depth Perception

Both eyes working together to give us the ability to judge the distance, the speed and the revolution of objects in space. Poor eye teaming can cause your eyes to misjudge the precise distance of your target, which in turn will cause your brain to misjudge the correct distance. If you perceive the target closer, you will react too soon. If you perceive it farther, you will react too late.

All of these factors can be trained and improved by our proven sports vision training system. To be a superior athlete you need to have superior visual skills. Our training will give you that competitive edge.

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My Dry Eye Story
Written By: | February 13, 2012

I am an Optometrist with Pepose Vision Institute and have had a dry eye condition for over a decade.  I have tried everything from over the counter drops and gels, prescription eye drops, warm towels and lid washes, to oral medications and supplements. All with limited success. At times my eyes are red, tired, teary, itch and this sometimes affects my vision. The worst times for me are in the Spring and Fall with allergies and in the winter with the cool dry weather. The newest testing and treatment equipment available in the United States is the Lipiview and Lipiflow system. In fact, we have one of the few systems in the US! The treatment was very simple, 12 minutes for each eye with an eye cup that is heated and massages the eyelid glands. Not uncomfortable at all. My eyes followed the reported study results with maximal effect in four weeks. I have noticed much more comfort, whiter eyes and I use drops much less then I normally would for this time of the year. The study suggests the treatment should be effective for 9 to 15 months and at that time it can be repeated.

I am a happy camper and know that many people with lipid layer deficiency, a type of dry eye, would also benefit with this new technology.  I am not completely drop-free but my eyes are clearer and more comfortable. Call our office to schedule your dry eye evaluation today to see if you would also be a good candidate for this treatment. Dr. Redfern recently posted a blog that explains the LipiFlow and LipiView systems. The video is available here: Breakthrough Treatment for Dry Eyes – LipiFlow

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Why Annual Eye Health Exams Are Always a Good Idea
Written By: | February 1, 2012

Good vision does not necessarily mean good eye health. I recently saw a patient for a routine eye exam. He was a healthy guy in his 40’s that had LASIK a few years back by Dr. Pepose. Vision was great and he was very happy with it. The exam was unremarkable until I looked at his fundus thru a dilated pupil. What I saw on his retina was a Hollenhorst Plaque, which is a cholesterol embolus that breaks loose from the carotid artery, which is located on the sides of our neck. This emboli lodges in the small vessels of our retina. A quick referral to his primary doctor and a carotid ultrasound confirmed the cholesterol deposits within the vessel walls. Proper medication, diet and exercise have greatly reduced his risk of stroke which may have gone undetected until there was a serious event. The moral of the story is to take the time once a year for an annual eye health exam, even if your vision seems fine.

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Specialty Contact Lenses
Written By: | September 15, 2011

At Pepose Vision Institute not only do we have surgical solutions to treat visual problems, but we also fit specialty contact lenses that can enhance your vision and comfort. Before considering LASIK, most people use some sort of correction in the form of glasses or contact lenses to help them see at distance, near or both. As of March 2008, 34 million Americans wear contact lenses. Most people can be fit into regular soft or rigid contacts; however, some people have problems that can not be helped with these standard types of lenses.
Some of the more common eye problems that require special contacts that we see and treat at Pepose Vision Institute are: Astigmatism, Presbyopia, Keratoconus, Corneal Scars, Eye Trauma, Eye Disease, Corneal Transplants, Irregular Corneas, Severely Dry Eyes and other eye conditions.
To help determine which lens would work the best requires advanced testing and measurements. At Pepose Vision Institute we have the latest and greatest testing equipment to evaluate vision potential and Topography, (Topography measures corneal surface irregularities.) We also have the most advanced trial contact lenses to evaluate the proper fit and power for best vision and comfort.
These are some of the lenses we have available, in addition to regular soft disposable and rigid Gas Permeable (RGP) contacts. Toric contact lenses to correct for astigmatism. Bifocal and multifocal contacts. Prosthetic contacts to hide corneal scars or irregular pupils. Hybrid contact lenses that have a rigid center with better optics for clear vision and a soft skirt for comfort and stabilization. Scleral contact lenses which are a larger rigid lens that is designed to vault over the entire cornea to provide good comfort and vision for patients with sever corneal issues.
If you, or someone you know, have any special issues with their eyes, or just need contact lenses feel free to set up an appointment for a thorough evaluation at our clinic. Call 636-728-0111 to schedule your appointment

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Treatments for Dry Eye Conditions
Written By: | May 16, 2011

Pepose Vision Institute is not just a premier destination for LASIK vision correction and other types of refractive surgery. We also offer a full range of primary eye care services. These include annual eye health examinations, contact lenses (including specialty contact lens fittings), and treatment of ocular disease such as cataracts, glaucoma, macular degeneration, and dry eyes.

Whether you suffer from cataracts or dry eye syndrome or you simply desire to maintain your ocular health, our eye care clinics provide the most advanced care available. We continually invest in the most state-of-the-art diagnostic equipment to provide unsurpassed care for our patients.

Dry Eye Syndrome

Dry eye disease, also known as keratoconjunctivitis sicca, is a condition that results in the inflammation of the eye and the tear-producing glands. This inflammation decreases the eye’s ability to produce normal tears that protect the eye from irritation and keep it moisturized and lubricated. The tear film is composed of three intermingling layers:

  • Oily layer – outermost layer prevents evaporation
  • Watery layer – middle layer moisturizes the eye
  • Mucous layer – inner layer allows adherence between the eye and the watery layer

A disruption of the function of any one or more of these layers can cause dry eye symptoms.

It’s estimated that 20 percent of Americans, women more often than men, suffer from dry eyes, which can cause a range of uncomfortable symptoms. Dry eyes are characterized by a scratchy, gritty, or burning feeling, redness, stringy mucus, and increased sensitivity to light. Wind, dry air, and other environmental factors are but a few of the causes.

Surprisingly, dry eye syndrome can also cause excessive watering eyes due to the tears lacking the proper balance of mucous, water, and oil to coat the eyes properly. Chronic dry eyes can lead to damage of the eye’s surface, an increased risk of eye infections, and eventually, the inability to produce tears. Left untreated, severe forms of dry eyes can even damage your vision. At our St. Louis, Missouri centers, we can help patients determine potential causes of their dry eye syndrome and identify appropriate dry eyes treatments.

Causes of Dry Eyes

Some common causes of dry eyes include:

  • Aging
  • Hormonal changes, such as pregnancy or menopause
  • Autoimmune diseases such as lupus, rheumatoid arthritis, and Sjogren’s Syndrome
  • Smoking
  • Environmental factors (such as smoke, dry or windy weather, heaters, air conditioners, dust, contact lens wear, prolonged computer use)
  • Allergies
  • Contact lens wear
  • Certain medications (such as decongestants, antihistamines, oral contraceptives, tranquilizers, diuretics)
  • Vitamin A deficiency
  • Inflammation of the eye’s tear-producing gland

LASIK or another type of refractive surgery can worsen or bring on dry eyes. Similarly, those with extreme dry eyes may be disqualified from undergoing LASIK surgery.

Treatments for Dry Eyes

Common treatment of dry eye syndrome includes the use of artificial tears or ointments. However, excessive or prolonged use of artificial tears can disrupt the natural production of tears, leading to further aggravation of the condition instead of providing desired relief.

Though there is no cure, those who suffer from dry eyes can come to our St. Louis, Missouri practice and learn about ways to manage the condition. We generally suggest a combination of the following dry eyes treatment options:

  • Lubricating tears and ointments
  • Punctal plugs, temporary or permanent
  • Special eyewear while sleeping such as goggles or moisture chambers
  • Omega-3 and Omega-6 Fatty Acid supplements such as HydroEye®
  • Restasis® therapy

HydroEye® SoftGels: HydroEye® SoftGels are recommended by many doctors and can give patients continuing relief from dry eyes, whatever the cause of the condition. The SoftGels contain a proprietary blend of nutrients that fight inflammation and help your eyes maintain a healthier tear film. These supplements were developed by ophthalmologists and nutritional scientists, manufactured according to the premier quality standards, and made from the finest ingredients. With continued use, HydroEye® SoftGels may give you uninterrupted relief from dry eyes. The treatment contains omega-3 and omega-6 fatty acids, vitamins, minerals, and other ingredients that help you maintain healthy tear production.

Restasis®: Often, the root cause of dry eye syndrome is inflammation of the eyes’ tear-producing gland; this inflammation can be triggered or made worse by allergies, smoking, prolonged computer use, and other factors mentioned above. Unlike artificial tears, which only temporarily relieve dry eyes, Restasis® Ophthalmic Emulsion actually stimulates your eyes to produce more tears, addressing the root cause of discomfort. Restasis® is a prescription eye drop that, when used twice daily, causes a noticeable increase in natural tear production that will continue to improve with time. Restasis® can be used in conjunction with artificial tears, though non-prescription eye drops will become less necessary as healthy tear production is restored. Restasis® has been well-tolerated by patients and is currently the only dry eyes treatment to actually increase tear production.

For more information on Dry Eye treatments please check on line at or call us at 636-728-0111


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Sunglasses Are Not Just For Fashion
Written By: | April 6, 2011

Spring is here and the thought of outside activities is on everyone’s mind. One thing that is extremely important to remember is UV protection for our eyes. Over-exposure to ultraviolet (UV) rays from the sun can cause eye damage and can lead to vision loss. Damage to the skin around the eye causes wrinkles, premature aging, and skin cancer.

UV-related eye conditions that can be prevented by good quality sunglasses include Cataracts, Pterygium (growth on eye), Macular Degeneration, Skin Cancer of lids, and Photokeratitis (sunburn on the cornea).

Most good quality sunglasses should have 100% UV protection. Polarization is a type of lens that blocks out scattered light or glare. Polarized sunglasses also have VU protection. For the sharpest, most comfortable vision out doors and in the car, look for sunglasses that are polarized.

Remember to bring your sunglasses with you when heading out the door. Weather you are young, old, or in between, we all need UV protection. You don’t need an appointment to visit our optical and have one of our experienced consultants help you with your selection. Sunglasses aren’t just an accessory.


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The Importance of Eye Safety in Sports
Written By: | February 4, 2011

Sports are the leading cause of eye injuries in children. Seventy-two percent of the injuries occurred in individuals younger than 25 years, 43% occurred in individuals younger than 15, and 8% occurred in children younger than 5. Obviously there are many long-term health and social benefits to playing sports, but 40,000 people each year find themselves in the emergency room because of a sports-related eye injury. More than 100,000 individuals a year visit their doctor because of an eye-related sports injury. The bottom line is that sports related eye injuries do happen, they can be severe, and they can cause permanent vision loss.

The most common eye injuries in sports are from something hitting an eye with force. Contact sports and sports that use balls, rackets, or sticks have a higher risk of this kind of injury. These injuries can be relatively minor, like a black eye, or more serious. Serious injuries include breaking the bones around the eye, bleeding inside the eye, retinal detachments, or rupturing the eyeball. Some of these injuries may result in permanent vision loss.

Other types of sports eye injuries occur when something cuts or pierces the eye, like a piece of glass, debris, or fingernails. These types of injuries can also cause permanent vision loss. Additionally, water and snow sports involve intense sunlight and require protection from ultraviolet light.

The good news is that 90% of sports-related eye injuries are preventable by simply using the correct protective eyewear or gear. When protective eyewear is fit properly it should not hinder performance. The American Academy of Ophthalmology and the American Academy of Pediatrics strongly recommend protective eyewear for all sports participants where there is a risk of eye injury. Regular eyeglasses and sunglasses do not provide very good protection of the eyes during sports. In fact, according to the National Eye Institute, sports participants using regular glasses or sunglasses are at higher risk of an eye injury than those participants not using anything at all. This is because the glasses themselves may become part of what injures the eye.

No matter what your sport, look for eye protection that is appropriate for the sport and fits properly. Some sports have standards for protective eyewear established by the American Society of Testing and Materials. The lenses or shields in this safety eyewear should be made of polycarbonate material, the strongest and most shatter-resistant material. By wearing protective eyewear, you can significantly decrease your risk of eye injury and keep yourself in the game.  Enjoy your winter sports and take care of your eyes!

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