Lifeguard vision project: oh, say, can they see?

Do you know how many of your lifeguards have sub-par vision? (Probably 1 in 10.)

Do you know how many of your lifeguards have prescription eyewear at home, but do not use it as work? (Probably 1 in 6.)

Do you know when your lifeguards had their last eye examination by an optometrist or ophthalmologist? (Most, never.)

These are just a few of the reasons why all aquatic facilitis should consider screening the vision of their lifeguards before the 1996 swim season.

During the summer of 1995, the staff at the Visual Fitness Institute (VFI) undertook a study to find the effects of glare, fatigue and tinted lenses on lifeguard vision. The study found that good quality tinted lenses were effective in reducing glare and improving the guards' contrast sensitivity, the ability to see well under variable lighting conditions. It also found that the majority of lifeguards were not asked about their vision before being hired or certified; were not required to provide proof of adequate vision before reporting to duty and that no procedures were in place to screen lifeguard vision. In its research, VFI found that very few states had vision standards in place.

Given this information, VFI initiated a lifeguard vision screening pilot program before the 1995 swim season. The purpose of the pilot program was to identify as many lifeguards as possible with subpar vision, and to develop procedures that would allow the vision screening of many lifeguards in a relatively short period of time, while minimizing the cost to the pilot agency.

The vision screening pilot program uncovered the following information:

* More than half of all guards taking part in the program, had never had an optometric (a specialist licensed to examine the eye for defects or the fitting of corrective eyewear) or ophthalmic (physician that specializes in the eye) eye examination.

* 10% of the lifeguards tested had sub-par vision (less than 20/30) many of whom said they knew that their vision was poor. (Using 20/20 as the measure of normal vision, the pilot program considered 20/30 as the vision standard for this program.

* 17% of the guards who participated in the vision screening said they had prescription eyewear at home--contact lenses or eyeglasses--but almost never wore it.

These findings are particularly significant, because of the critical importance that vision plays in the guards' ability to recognize emergencies and react swiftly. At its most basic level, lifeguarding is a vigilant task," requiring guards to maintain a high level of readiness to detect and respond to infrequent and unpredictable situations. One minute a guard may be scanning the crowded pool, reminding children not to run on the pool deck, and the next minute spotting a swimmer in trouble and effecting a rescue. Routine? Yes, but only if the guard sees the troubled swimmer before he or she slips beneath the surface and loses consciousness. Even at the most crowded pools or beaches, situations that require lifeguard response are sporadic. To respond effectively, on-duty guards must be able to survey the scene systematically; shut out distractions and irrelevant stimuli; and then process and analyze all information in order to react appropriately when the situation warrants.

A Hostile Environment 

Changing light conditions and other environmental factors make the guards' vigilant task more difficult. They must contend with surface glare--a leading cause of eyestrain and fatigue--caused by bright sunlight and artificial light reflecting off the surface of the water. Vision is also affected by conditions that alter light waves. For example, guards looking below the water's surface, are impeded by distortion caused by the refraction of light, and movement of the water. Unless the guard can accurately discriminate shapes and shadows below the surface of the water, from a distance and under adverse lighting conditions, he or she may be slow to react and will lose valuable time.

The Eyes Lead ... The Body Follows

Besides environmental factors, lifeguard vision is also affected by the presence or absence of individual visual skills. Since 80% of all the information we receive is visual, it is essential to make sure that every on-duty lifeguard has the advantage of both excellent vision and superior visual skills.

There are many components involved in the visual skills guards need to work effectively. To scan properly, guards must have well-developed static and dynamic visual acuity, the ability to see stationary and moving targets at a distance. They must also have accurate contrast sensitivity, the ability to see clearly under variable fighting conditions--bright sun to shadows; overcast daylight to dusk and twilight to night. A lifeguard simply cannot be effective unless he or she has good vision and good contrast sensitivity. Also vital are peripheral vision and spatial localization, which increase the guards' awareness of their surroundings and any developing situations that may require a quick response.

Excellent depth and distance perception make it possible for the guard to determine a swimmer's precise location and to reach that swimmer quickly. Visual recognition time and fixation ability will help guards see swimmers, recognize changes in stimuli, analyze situations, and react appropriately. Focusing ability allows lifeguards to shift their visual gaze rapidly from near-to-far and from distance to close-up.

Beyond visual ability and skills, guards must be able to process what they see. Visual cognition skills greatly affect lifeguard performance. Me importance of visual memory and visual concentration cannot be overstated. Visual memory is the ability to retain a picture in the mind's eye for later retrieval. It is as if the lifeguard breaks up the scene being scanned into a series of short, manageable segments, and freezes those images in short-term memory.

Visual concentration is the ability to stay focused and concentrate, in spite of adverse environmental conditions and stress-inducing distractions, such as crowds, noise, discomfort and fatigue. Lifeguards with less than normal visual acuity, poor depth perception, impaired color vision, or other visual skill deficiencies must overcome serious challenges to react quickly and accurately in an emergency.

To See or Not to See

Corrective eyewear-eyeglasses or contact lenses--is an essential tool often overlooked by lifeguards. Contact lenses offer certain advantages over eyeglasses, not the least of which is improved peripheral (side) vision, and clarity without fogging. Lifeguards can choose between two types of contact lenses: rigid, gas permeable or soft lenses. Both types offer excellent visual acuity. However, soft lenses may be more comfortable and are less likely to become displaced during a rescue. It is suggested that lifeguards entering the water close their eyes momentarily to prevent the lens from loosening. If they are going to lose a lens it will most likely happen when first entering the water. Disposable lenses are also recommended because of increased exposure to water, wind, sun, dust and dirt.

Not all lifeguards can be fitted with contact lenses, and in those cases, eyeglasses are necessary, though the peripheral (side) vision will be restricted. The lenses should be plastic, preferably shatter-proof polycarbonate, and polarized to reduce glare and provide optimum UV protection. Polarized polycarbonate lenses are new on the market and may not be available at all optical facilities. A well-fitting elastic strap should be used to keep the eyeglasses in place during a rescue. Depending on age and vision prescription, some guards may be appropriate candidates for refractive surgery. There are several outpatient refractive procedures that will reduce or eliminate nearsightedness and astigmatism, without corrective lenses.

Sunlight Takes Its Toll

The 1995 study also reaffirmed the importance of high quality sunglasses. Bright sunlight takes its toll on working guards, mentally and physically. Besides eyestrain and physical discomfort, prolonged exposure to bright sunlight and ultraviolet rays can precipitate the formation of cataracts in later life. The study also showed that polarized lenses reduced glare and improved the guards' ability to see well under variable lighting conditions, i.e., contrast sensitivity. For these reasons, lifeguards are advised to consult an eye care practitioner for help in selecting the best possible, distortion-free polarized sunglasses.

Vision Screening Recommended

The initial vision screening pilot program was conducted at sever facilities in 1995. Integrating what was learned from the pilot program, it is anticipated that more lifeguards will be screened. It is hoped that other aquatic facilities will initiate vision awareness and screening programs for their lifeguards, perhaps in cooperation with local eye care practitioners. The cost of the screening is relatively small in comparison to its benefits.

Understanding the different elements of accurate vision is vital to the aquatic profession. The most important element to a rapid and effective water rescue is recognizing the distressed swimmer. Taking steps to screen, properly equip and properly train guards can only make the job of saving lives easier.

For more information on vision screening for lifeguards, contact the Visual Fitness Institute at [phone].