Difficult at dusk? Illuminating the debate on cricket ball visibility.

OBJECTIVES: Investigate the visibility of new and old red, white and pink cricket balls under lighting and background conditions experienced during a day-night cricket match. DESIGN: We modelled the luminance contrast signals available for a typical observer for a ball against backgrounds in a professional cricket ground, at different times of day. METHODS: Spectral reflectance (light reflected as a function of wavelength) was derived from laboratory measurements of new and old red, white and pink balls. We also gathered spectral measurements from backgrounds (pitch, grass, sightscreens, crowd, sky) and spectral illuminance during a day-night match (natural afternoon light, through dusk to night under floodlights) from Lord's Cricket Ground (London, UK). The luminance contrast of the ball relative to the background was calculated for each combination of ball, time of day, and background surface. RESULTS: Old red and old pink balls may offer little or no contrast against the grass, pitch and crowd. New pink balls can also be of low contrast against the crowd at dusk, as can pink and white balls (of any age) against the sky at dusk. CONCLUSIONS: Reports of difficulties with visibility of the pink ball are supported by our data. However, our modelling also shows that difficulties with visibility may also be expected under certain circumstances for red and white balls. The variable conditions in a cricket ground and the changing colour of an ageing ball make maintaining good visibility of the ball a challenge when playing day-night matches.

Profile of Athletes With a Vision Impairment: Exploring Demographics and Ocular Pathologies of Athletes in Three Paralympic Sports.

OBJECTIVE: This study aimed to explore the profile of athletes with a vision impairment who compete in three Paralympic sports (goalball, vision impairment judo, and blind football). DESIGN: Descriptive and association analyses of the vision impairment athletes' profile were conducted. RESULTS: The typical athlete profile was a male (65.1%), aged 26-34 yrs (39.7%), from Europe (38.8%), representing a country with a high income (46.1%), and was diagnosed with a retinal-related ocular pathology (38.9%). In all three sports, the ages of the athletes were similar. In goalball, most athletes were from Europe, represented countries with a high income, and were diagnosed with retinal-, globe-, or neurological-related pathologies. In vision impairment judo, the majority of athletes were from Asia, represented countries with an upper middle income, and were diagnosed with retinal-, global-, or neurological-related pathologies. In blind football, most athletes were from Europe, represented countries with an upper middle income, and were diagnosed with retinal-, neurological-related ocular pathologies, or glaucoma. CONCLUSIONS: The homogeneity of the athletes' profile suggests that an effort is needed to target other parts of the vision impairment population to take part in vision impairment sports. Differences in the athletes' profiles across the sports provide information that may be useful for sport-specific talent identification.

Impact of Running With and Without a Guide on Short Distance Running Performance for Athletes With a Vision Impairment.

OBJECTIVE: This study aimed to investigate the difference of running with or without a guide on running performance (100, 200, and 400 m) for athletes with a vision impairment. DESIGN: Data including athletes' and guides' sex, age, and race times were extracted from 11 elite competitions. RESULTS: Male athletes predominantly ran without a guide (100 m = 91.4%, 200 m = 88.1%, 400 m = 84.8%), whereas female athletes mainly ran with a guide (100 m = 60.5%, 200 m = 80.0%, 400 m = 72.0%). No significant difference in 100-m race times was found between male athletes with or without a guide ( P = 0.647). For the 200 m ( P = 0.001) and 400 m ( P = 0.030), race times were significantly slower for male athletes running with a guide (mean rank 200 m = 36.80, 400 m = 33.57) compared to without a guide (mean rank 200 m = 19.43, 400 m = 21.69). Conversely, 100- ( P = 0.015), 200- ( P = 0.025), and 400-m ( P = 0.029) race times were significantly faster for female athletes with (mean rank 100 m = 18.25, 200 m = 13.71, 400 m = 11.00) compared with without a guide (mean rank 100 m = 27.74, 200 m = 22.67, 400 m = 21.69). CONCLUSIONS: Running with a guide affects vision impairment athletes' race times. The influence of running with a guide, and the gender mix of vision impairment athlete and guide, should be considered in any research with the aim of establishing a new classification system for vision impairment athletes.

Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute.

Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.

Barriers to and Facilitators of Physical Activity: A Qualitative Study from the Perspective of Individuals Living with Sight Loss in Cambridgeshire.

Physical inactivity is a prevalent concern amongst adults living with sight loss. It is essential to understand why these individuals are inactive and how we can increase physical activity levels among them. Therefore, this study aims to explore the barriers and facilitators to physical activity for individuals living with sight loss. Seven individuals with self-reported sight loss living in Cambridgeshire were recruited for three focus groups. Focus group data were analysed using thematic analysis to identify key themes. Seven themes which represented a barrier, or a facilitator were identified: transport, accessing information, one size fits all, negative previous experience, visually impaired sport, women in disability sport, and taster days. To increase physical activity levels amongst those living with sight loss, interventions need to be focused on the organisational level. This includes producing more accessible environments that can be produced by providing training for sport and physical activity professionals and by ensuring the physical environment is inclusive for those living with sight loss.

The effects of simulated vision impairment on performance in football.

Footballers with vision impairment (VI) are eligible to compete in the Para sport if they meet a minimum impairment criteria (MIC) based on measures of their visual acuity (VA) and/or visual field. Despite the requirements of the International Paralympic Committee Athlete Classification Code that each sport uses an evidence-based classification system, VI football continues to use a medical-based system that lacks evidence to demonstrate the relationship between impairment and performance in the sport. The aim of this study was to systematically simulate vision loss to establish the minimum level of impairment that would affect performance in futsal. Nineteen skilled sighted players completed tests of individual technical skill and anticipation performance under six levels of simulated blur that decreased both VA and contrast sensitivity (CS). VA needed to be reduced to a level of acuity that represents worse vision than that currently used for inclusion in VI football before meaningful decreases in performance were observed. CS did not have a clear effect on football performance. These findings produce the first evidence for the minimum impairment criteria in VI football and suggest a more severe degree of impairment may be required for the MIC.

Effectiveness of music-based interventions to address well-being in people with a vision impairment: a scoping review.

OBJECTIVES: The objectives of this review were to identify the types of music-based interventions and associated accessibility challenges for people who have visual impairment (VI) and their reported effects on psychological, physiological and social well-being. DESIGN: A scoping review was developed according to the Joanna Briggs Institute methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and guidelines. A narrative synthesis was conducted to map out the types of music-based interventions undertaken and to compare the therapeutic outcomes. The studies were evaluated according to the music reporting checklist. RESULTS: In total 5082 records were identified, 69 full-text articles were screened and 13 studies were included. Eleven studies included younger children and teenagers, two focused on adults with acquired VI. Ten studies involved active music therapy strategies and three used passive music listening. Eleven of the studies focused on social outcomes and two reported mental health. Although the studies reported that music-based intervention strategies improved psychosocial well-being in people with a VI, conclusions could not be drawn as robust outcome measures were not generally used and only four of the studies included any statistical analysis. CONCLUSIONS: Although potential was evident, details of intervention protocols and training requirements were not sufficiently reported and further, high-quality evidence-based studies are required.

Effect of manipulating the vergence/accommodation and image size mismatches of the ±2D flipper test on the frequency and precision of accommodative facility.

PURPOSE: The ±2.00 D accommodative facility test presents several limitations, including the lack of objective information and inherent characteristics such as vergence/accommodative conflict, change in apparent size of the image, subjective criteria for judging blur and motor reaction time. By using free-space viewing conditions and an open-field autorefractor to monitor the refractive state, we examined the impact of manipulating these factors on the qualitative and quantitative assessment of accommodative facility. METHODS: Twenty-five healthy young adults (24.5 ± 4.5 years) took part in this study. Participants performed three accommodative facility tests (adapted flipper, 4D free-space viewing and 2.5D free-space viewing) under both monocular and binocular conditions in random order. A binocular open-field autorefractor was used to assess the accommodative response continuously, and these data were used to characterise accommodative facility quantitatively and qualitatively. RESULTS: There were statistically significant differences between the three testing methods both quantitatively (p < 0.001) and qualitatively (p = 0.02). For the same accommodative demand, a lower number of cycles was obtained for the adapted flipper condition in comparison with the 4D free-space viewing test (corrected p-value < 0.001, Cohen's d = 0.78). However, this comparison did not reach statistical significance for qualitative measures of accommodative facility (corrected p-value = 0.82, Cohen's d 0.05). CONCLUSIONS: These data provide evidence that the qualitative assessment of accommodative facility is not influenced by the inherent limitations of the ±2.00 D flipper test. The use of qualitative outcomes by incorporating an open-field autorefractor allows examiners to increase the validity of the accommodative facility test in both clinical and research settings.

The global state of play: A study of the demographic characteristics of disability golfers.

BACKGROUND: Golf is a moderate-intensity physical activity that provides positive physical and mental health benefits. However, the inclusiveness of the sport for individuals with disabilities globally is unknown. OBJECTIVE: To characterize the demographics and disability characteristics of individuals engaging in disability golf globally. It was hypothesized that the majority of participants would be middle-aged, male, and from countries with higher gross domestic product, similar to the nondisabled population. DESIGN: Descriptive, cross-sectional analysis using European Disability Golf Association (EDGA) database. SETTING: Various international golf tournaments. PARTICIPANTS: Golfers (n = 1734) with disability from 44 countries registered with the EDGA (2017-2021). INTERVENTIONS: Not applicable. MAIN OUTCOMES: Descriptive analyses of frequencies, distributions, and means differences of demographic characteristics (age, gender, type of disability, level of handicap, golf cart use, and country of origin) of golfers with disability were performed. Data provided analysis of the association between number of participants and a country's gross domestic product (GDP). RESULTS: Individuals had a mean age of 52.5 (±15.6) years: 1589 (91.6%) male and 145 (8.4%) female. Twenty-three countries had female participation. The most commonly reported primary disability diagnoses were neurologic (24.8%), orthopedic (21.4%), and amputation below the knee (14.4%). Neurologic impairments (24.7%) were most common in men and orthopedic impairments (29.7%) were most common in women. Individuals with neurological impairments (27.4%) most frequently required golf carts to play. The GDP of a country had a positive correlation (r = 0.68) with the number of registered golfers with disability. CONCLUSION: Golf is played by individuals with a variety of disabilities and provides numerous benefits. However, there is an underrepresentation of youth, women, and individuals with certain impairments and from lower-income countries. These are the potential areas of opportunity to improve engagement and inclusiveness of golf.

Delphi Study: Designing Training to Enable Visual Impairment Services to Promote Physical Activity.

Research suggests adults with visual impairment would increase their physical activity (PA) if they were advised to by a professional working in visual impairment services. However, there are no training programs which are targeted at enabling these professionals to promote PA. Therefore, this study aims to inform a UK-based training program which facilitates PA promotion within visual impairment services. A modified Delphi technique was used, consisting of a focus group and two rounds of surveys. The panel included 17 experts in round one, and 12 experts in round two. Consensus was defined as equal to or greater than 70% agreement. The panel agreed training should: educate professionals on PA benefits, injury prevention, and wellbeing, address myths associated with PA, address health and safety concerns, help professionals to find local PA opportunities, and include a networking session for professionals in visual impairment services and local PA providers. The panel agreed training should also target PA providers and volunteers for visual impairment services, and that training should be delivered online and in-person. In conclusion, training should provide professionals with the capability to promote PA and to establish stakeholder partnerships. The present findings can inform future research which tests the panel's recommendations.

Development and validation of a new photographic scale to grade lid wiper epitheliopathy.

PURPOSE: Lid wiper epitheliopathy (LWE) is a clinical sign that has been associated with dry eye disease (DED) and contact lens discomfort (CLD). This study describes the development, validation and graders' preference of a new photographic scale for LWE, the Photographic Lid Wiper Epitheliopathy (PLWE) scale. METHODS: The PLWE grading scale was developed using LWE images selected from 57 screened patients (≥18 years of age) with confirmed LWE in both eyes. To validate the PLWE scale, a set including 20 images showing varying degrees of LWE from none to severe was chosen. To assess grading validity and grading reliability, observers were asked to grade the selected images using the PLWE and another commonly used subjective LWE grading protocol (Korb) on two separate sessions. RESULTS: The mean grade (±SD) of all images was not statistically significant different between the PLWE scale (1.55 ± 0.44) and the alternative grading scale (Korb, 1.47 ± 0.54) (ANOVA F1, p > 0.05). The average difference from the mean of all graders was 0.03 ± 0.53 using the PLWE scale and 0.06 ± 0.57 when using the Korb protocol (ANOVA F1, p > 0.05). The Coefficient of Repeatability was 1.04 and 1.12 for the PLWE and Korb scales (p > 0.05). Ninety-five percent of the graders found PLWE easier to use than Korb and the same percentage would consider using the PLWE scale in clinical practice. CONCLUSION: The format of the PLWE is similar to other anterior segment visual grading scales and this study revealed an ease of use preference for employing the PLWE by the graders. The presence of LWE has been associated with DED and CLD, and the addition of this new photographic scale could facilitate clinical judgement and record keeping of LWE in clinical practice.

Feasibility of physical activity promotion in eyecare and sight loss services to improve the health of adults with sight loss: a survey.

PURPOSE: (1) To identify if adults with uncorrectable sight loss would increase their physical activity (PA) following advice from general healthcare, eyecare or sight loss service professionals. (2) To identify what resources could be provided alongside advice from a professional to facilitate PA. MATERIALS AND METHODS: Survey data from 100 UK adults with uncorrectable sight loss were analysed. Adjusted logistic regression models were used to examine the association between participant characteristics, and the likelihood that participants would increase PA if advised to by different professionals. RESULTS: Most of our sample would increase their PA if advised to by a general practitioner (GP) (n = 78), ophthalmologist or optometrist (n = 70) or a low vision rehabilitation officer (n = 75). Thirty-one participants would increase their PA if advised to by a dispensing optician. Participants with a history of anxiety and depression were less likely to report they would increase their PA based on advice from a GP (p = 0.002). Sight loss specific and community-based PA groups, exercise specialist support, a sighted guide, and a travel plan, were considered by most participants to be useful facilitators of PA. CONCLUSION: The results suggest eyecare and sight loss service professionals could facilitate increases in PA among adults with sight loss.Implications for rehabilitationPhysical activity levels among populations with sight loss are critically low, and inactivity increases the risk of chronic conditions and premature mortality within these populations.GPs, optometrists, ophthalmologists, or low vision rehabilitation officers could play a pivotal role in increasing physical activity levels among people with sight loss, by providing physical activity advice during consultations.Professionals advising people about physical activity should have the knowledge, and opportunity, to refer people with sight loss to accessible physical activity groups or services.

Perceived Facilitators and Barriers to Participation in Golf for People With Vision Impairment: A Qualitative Study.

OBJECTIVES: This study aimed to identify facilitators and barriers to participation in vision impaired golf. DESIGN: Semistructured interviews were conducted with 12 vision impaired golfers, 10 guides, and 5 novices during the British VI Golf Open tournament in August 2021. RESULTS: Qualitative content analysis identified the benefits, facilitators, and challenges of playing vision impaired golf. The role of guides and future developments of the sport were furthermore identified. The benefits extend beyond those related to health, including personal development and a sense of purpose for players and of reward for guides. Facilitators were largely organizational and having appropriate support and a guide. The challenges to playing and guiding were practical, financial, and logistical. The need to attract a more diverse range of players, along with a reconsideration of the eligibility criteria, was central to the perceived sustainability of vision impaired golf. CONCLUSIONS: These results highlight the practical, financial, and logistical challenges contributing to vision impaired golf activity limitations and participation restrictions. Because of the health, personal, and psychosocial benefits, ways of providing practical, financial, and support networks to facilitate engagement in vision impaired golf should be sought. An evidence-based, sport-specific eligibility system was thought to be critical for the future promotion of vision impaired golf.

Evidence-based classification in golf for athletes with a vision impairment: A Delphi study.

Vision-impaired (VI) golf is a global para-sport currently played under several different classification systems under different bodies. This study aimed to gather expert opinion to determine whether the current classification systems are fit for the purpose intended and to identify any particular issues where VI impacts the game of golf for the disabled (G4D). A panel of 20 participants with expertise in G4D took part in a three-round Delphi study. The panel agreed that the current classification system(s) for VI golf did not or only partially fulfilled the aim to minimise the impact of VI on the outcome of competition and that there should be one, internationally recognised, classification system. It was agreed that other metrics of VI, in addition to the measurement of visual acuity (VA), need to be considered. Intentional misrepresentation of VI was identified as a cause for concern. The panel agreed that the current classification system does not fully achieve its purpose. Any changes that are made to these classification systems need to be evidence based specific to VI golf. Further research is required to determine how measures of VI affect golfing performance and whether other metrics other than VA are required.

In vivo CRISPR screens reveal the landscape of immune evasion pathways across cancer.

The immune system can eliminate tumors, but checkpoints enable immune escape. Here, we identify immune evasion mechanisms using genome-scale in vivo CRISPR screens across cancer models treated with immune checkpoint blockade (ICB). We identify immune evasion genes and important immune inhibitory checkpoints conserved across cancers, including the non-classical major histocompatibility complex class I (MHC class I) molecule Qa-1b/HLA-E. Surprisingly, loss of tumor interferon-γ (IFNγ) signaling sensitizes many models to immunity. The immune inhibitory effects of tumor IFN sensing are mediated through two mechanisms. First, tumor upregulation of classical MHC class I inhibits natural killer cells. Second, IFN-induced expression of Qa-1b inhibits CD8+ T cells via the NKG2A/CD94 receptor, which is induced by ICB. Finally, we show that strong IFN signatures are associated with poor response to ICB in individuals with renal cell carcinoma or melanoma. This study reveals that IFN-mediated upregulation of classical and non-classical MHC class I inhibitory checkpoints can facilitate immune escape.

Learning retinoscopy: A journey through problem space.

PURPOSE: Retinoscopy is a skill that requires the integration of procedural skill and declarative knowledge. Whilst the actual technique is simple, retinoscopy is a complex skill to acquire and is one that students often find challenging. This study compared the strategies that novices, third-year students and experts use when performing retinoscopy, with the aim of identifying the key stages of learning that may enlighten teaching practice. METHOD: This study employed a protocol-based approach in which the verbal protocols and cognitive strategies of novices, students and experts were recorded and then subjected to 'problem space' analysis. RESULTS: Clear differences existed when the retinoscopy of novices, students and experts was directly compared using a standardised simulated task. Experts were more accurate in performance and used defined strategies to reach the goal. The presence of these strategies significantly predicted the accuracy of the retinoscopy result. CONCLUSION: This study highlights the importance of meta-cognitive strategies and the need for an adequate theoretical foundation in skill acquisition. The underpinning knowledge provides a pedagogic tool that specifies activities which are beneficial to learning a clinical skill.

Fishing Participation, Motivators and Barriers among UK Anglers with Disabilities: Opportunities and Implications for Green Social Prescribing.

Green social prescribing, which includes the referral of patients to nature-based activities, could exacerbate inequalities between people with disabilities and people without. Research suggests fishing could be more inclusive relative to other outdoor sports. To understand if fishing is an inclusive sport, and the potential benefits and barriers to prescribing fishing, the present study compared participation, motivators and barriers to fishing, between anglers with and without disabilities. UK adults were invited to participate in an online survey. Chi-square tests examined differences between anglers with and without disabilities regarding the type of fishing anglers engaged in, the frequency of fishing, the length of time spent fishing, motivators for fishing and barriers to fishing. Among 1799 anglers (97.5% male), 292 (16.2%) anglers reported having a disability. Most anglers with disabilities were over 55 years old (56.5%). There was no difference in fishing participation, or motivators for fishing, between anglers with and without disabilities; however, anglers with disabilities were more likely to report 'costs', 'lack of transport' and 'having no one to go with them' as barriers. Overall, there appeared to be no differences in fishing participation between anglers with versus without disabilities, although additional barriers to participation may exist.

Music-based interventions to address well-being in people with a vision impairment: protocol for a scoping review.

INTRODUCTION: Music-based interventions are used to improve well-being in individuals who are psychologically vulnerable and have long-term illnesses. To date, no study has systematically assessed the literature on music-based interventions aimed at improving well-being in people who have a vision impairment (VI). The purpose of the current protocol is to provide the methodology for a scoping review, to explore the therapeutic outcomes and strategies used in music-based interventions aimed specifically at people with a VI. METHODS AND ANALYSIS: This scoping review protocol was developed according to the Joanna Briggs Institute methodology and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist and guidelines. The anticipated start date for this study was July 2021. The proposed review will include studies that use music therapeutically as part of a treatment intervention for all VI populations. Studies that meet the inclusion criteria with regards to population, concept and context will be included. Electronic database searches will be conducted independently by two researchers and include MEDLINE, EMBASE, CINAHL Plus, PsycINFO and Web of Science. Further searches will include the reference lists of included studies and grey literature. A narrative synthesis will be conducted to map out the types of therapeutic music interventions undertaken and to compare therapeutic outcomes. ETHICS AND DISSEMINATION: As the methodology of this study consists of collecting data from publicly available articles, it does not require ethics approval. The findings of the planned scoping review are important to guide the development of future interventions, or strategies, that will attempt to use music to improve well-being in people with a VI. The results will be disseminated through a peer-reviewed publication and conference presentations.

A valid and reliable test of technical skill for vision impaired football.

OBJECTIVES: The International Paralympic Committee requires international federations to develop and implement sport-specific classification guidelines based on scientific evidence. Performance tests are key to developing new evidence-based criteria in football for athletes with vision impairment (VI). Therefore, the aim of this study was to develop a valid and reliable test of technical performance for VI football. METHODS: To assure content and face validity, the Vision Impaired Football Skills (VIFS) test was based on recommendations from experienced players and coaches. To test construct validity, we compared 24 sighted football players split into two groups based on highest-level of performance but matched on experience. To test reliability participants completed the VIFS three times on two separate days. RESULTS: Results supported construct validity through detecting differences in performance times between the two groups (p = .004, g = 1.28 95% CI = 0.41 - 2.15). Bias between visits (.54s ± 2.93s; 95% LoA = -5.21- 6.29) and intraclass correlations (.81, 95% CI = .56 - .92) showed between-day agreement and reliability. Within-day reliability was good after a familiarisation trial. CONCLUSIONS: Results support the suitability for the VIFS test for classification research. Future work should establish feasibility for players with a VI.

The Relationship Between Visual Function and Performance in Para Swimming.

BACKGROUND: Paralympic swimmers with vision impairment (VI) currently compete in one of the three classes depending on their visual acuity (VA) and/or visual field. However, there is no evidence to suggest that a three-class system is the most legitimate approach for classification in swimming, or that the tests of VA and visual field are the most suitable. An evidence-based approach is required to establish the relationship between visual function and performance in the sport. Therefore, the aim of this study was to establish the relationship between visual function and performance in VI Para swimming. The swimming performance of 45 elite VI swimmers was evaluated during international competitions by measuring the total race time, start time, clean swim velocity, ability to swim in a straight line, turn time, and finish time. Visual function was measured using a test battery that included VA, contrast sensitivity, light sensitivity, depth perception, visual search, and motion perception. RESULTS: Results revealed that VA was the best predictor of total race time (r = 0.40, p < 0.01), though the relationship was not linear. Decision tree analysis suggested that only two classes were necessary for legitimate competition in VI swimming, with a single cut-off between 2.6 and 3.5 logMAR. No further significant association remained between visual function and performance in either of the two resulting classes (all |rs|< 0.11 and ps > 0.54). CONCLUSIONS: Results suggest that legitimate competition in VI swimming requires one class for partially sighted and another for functionally blind athletes.