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PubMed1975

Color vision: blue deficiencies in children?

Recent publicized reports based on the use of the Farnsworth Panel D-15 test suggest that a large percentage of young children have a deficiency of blue vision (tritan type). In our study, 413 school children (ages 3 to 10) were tested with both the Farnsworth Panel D-15 test, as well as the A.O. H-R-R plates. None of the children failed either test for blue-yellow vision when traditional scoring instructions were observed. As in previous reports, we find that the children make a number of minor errors which adults rarely make. These errors show marked age-related patterns, being more frequent in younger children. However, further analysis of these errors revealed that the relative frequency with which particular error types were made on the D-15 test was significantly correlated with the existing perceived color difference data for the visually normal adult population. In addition, retesting significantly reduced all error types and reversing the test sequence demonstrated that most of the minor errors were made in the last half of the test regardless of the color vision task. The overall increase in the number of minor test errors seen with young children seems unrelated to color defects. The modified scoring methods in conjunction with the characteristics of the Panel D-15 test design account for the high percentage of errors classified as errors of blue vision.

Age Factors↗
PubMed1988

Sahlgren's Saturation Test for acquired dyschromatopsia: increased lightness enhances sensitivity.

Sahlgren's Saturation Test (SST) is a simple sorting test designed for the detection and grading of acquired color vision defects. Like other pigment-based color vision tests, the SST color samples have medium lightness, i.e., they belong to the intermediate part of the gray scale. We tested normal controls and subjects with congenital or acquired dyschromatopsia with five SST versions that differed only in the amount of lightness. The sensitivity of the test increased considerably with increasing lightness. Therefore, the lightness level of SST has now been changed from 30 to 10 Natural Color System units.

Color↗
PubMed1992

The Ishihara Test: on the prevention of job discrimination.

Experiments were carried out to answer questions relative to the use of the 24-plate edition of the Ishihara Test for Colour-Blindness as a screening instrument for detecting the presence of inherited color defective vision. Subjects and their numbers varied between some experiments. Some subjects had normal color vision and others had inherited color defectiveness as confirmed with a Nagel anomaloscope. Most of the 157 subjects who participated in the experiments were either young deaf college students or police recruits with normal hearing who did not pass the Ishihara Test during their respective visual screening processes. Some hearing faculty and staff participated as part of Experiment 2. Item analysis and statistics applied to test the significance of differences between group means were applied to derive the following results: (a) test-retest reliability for the Ishihara is high both for persons with inherited color defectiveness and normal color vision; (b) persons making fewer than five errors on the first 13 plates made common incidental (nontypical) errors not related to color defective vision; and (c) five (5) or more errors was identified with some degree of inherited color defective vision, and subsequent referral for additional color vision diagnostics is warranted. Failure to utilize the recommended "pass-fail" criterion and/or to allow clients who fail color vision screening recourse to additional testing to establish type and degree of color defective vision may unnecessarily lead to job discrimination and/or interfere in a negative manner with the career selection process.

Adolescent↗
PubMed2000

[The clinical application of different brightness and different saturation D-15 tests].

PURPOSE: To compare the clinical application of different brightness and different saturation D-15 tests. METHODS: Eighteen normal subjects (30 eyes), 19 cases (38 eyes) of congenital color vision defects and 36 cases (59 eyes) of eye diseases were tested with Panel D-15 test, Hann's double D-15 test, middle and low saturation CAS-PI (Psychological Institute, Chinese Academy of Sciences) D-15 tests. RESULTS: A few of the normal eyes made minor errors in the low saturation D-15 tests. All of the protanopes and deuteranopes could be detected correctly. Protanomalias and deuteranomalias showed normal arrange or some type of abnormal arranges in all of the 5 sets of D-15 tests. In sick eyes, the abnormal rates were the highest in the low saturation D-15 tests and the lowest in Panel D-15 test. CONCLUSION: The five sets of different brightness and different saturation D-15 tests had similar efficiencies of detecting congenital color vision defects. The abnormal rates of CAS-PI(4/5)D-15 tests and the CAS-PI(2/5)D-15 tests were similar to those of Panel D-15 test and Hann's Double D-15 test. Both tests can be used in the clinical setting.

Adolescent↗
PubMed1991

[Value of very low voltage halogen lighting of desaturated panel D 15 test in established glaucoma].

The colour vision of a first group of glaucomatous patients was tested with the desaturated Panel D 15 test, first illuminated by a 300 lux Macbeth lamp, then with a very low voltage 1000 lux halogen lamp. In addition to the recording of 80% cases of dyschromatopsia, in line with previously published data, we demonstrated a great number (33.3%) of red-green axis anomalies under Macbeth light and, paradoxically, even more under halogen light (53.3%). To explain this high percentage of red-green axes under halogen light, we discuss the influence of luminance and emission spectrum of the light source. We conclude that the use of high luminance halogen light is capable of revealing concealed Verriest type II dyschromatopsias probably due to a specific fragilisation of the red-green channels induced by the glaucoma disease. This original colour vision testing procedure applied on established glaucomatous patients enabled us to easily obtain a factor of severity in the course of the disease.

Adult↗
PubMed1978

[Discrimination curve of color hues].

The hue discrimination curve has been studied in 48 cases of acquired dyschromatopsias not as it is the rule in relation with the nosology but in relation with the classifications as they are given by the test of Farnsworth. The results show with evidence different characters according to the type of dyschromatopsia: protan deutan or tritan.

Color Perception Tests↗
PubMed2000

Use of the Mollon-Reffin minimalist color vision test with young children.

PURPOSE: We evaluated the Mollon-Reffin Minimalist (M-R M) color vision test to determine how successfully young children can perform the task and to compare success rates with the American Optical Hardy Rand Rittler (HRR) test and a preferential-looking type test based on the F2 plates (the Pease-Allen color test [PACT]). METHODS: Participants included 146 children (aged 3-10 years) and 32 older subjects (aged 11-39 years). The M-R M test uses 3 series of colored caps coinciding with protan, deutan, and tritan confusion axes, with 6 saturations along each axis. The observer must identify a single colored cap from gray caps of varying lightness. The PACT test consists of 2 cards with targets for detecting red-green and blue-yellow color deficiencies. The tester judges the location of the target on the basis of the child's looking and/or pointing responses. The HRR was performed according to standard instructions, although a more flexible scoring protocol was also used. RESULTS: A significant difference in the children's performance between the "test" item of the 3 tasks emerged (Cochran Q test, P<.001): all children successfully completed the M-R M, 90% successfully completed the PACT, and 88% successfully completed the HRR. Few errors were made on the M-R M red-green series, even among children aged 3 to 4 years, although errors were made with the least saturated blue-yellow cap at all ages. Recommendations are made for the use of the M-R M with children. CONCLUSIONS: The M-R M test can be performed by young children and may prove to be especially useful for detecting and monitoring acquired color vision defects.

Adolescent↗
PubMed1998

Acquired colour deficiency in patients with Parkinson's disease.

The blue cone pathway is reported to be affected early in Parkinson's disease (PD) and acquired type three (tritan) defects may occur. Sixty-one patients attending a treatment and rehabilitation centre for PD were examined with clinical colour vision tests. Seven of 13 patients, for whom the diagnosis of PD was equivocal or who had other medical conditions, were identified as having tritan colour deficiency. Results for the remaining 44 PD patients were compared with 40 age matched controls. Ten PD patients (22.7%) had tritan defects. Tritan defects were not found in the control group but performance on some tests was age related. We conclude that clinical tests for tritan colour deficiency are unlikely to be helpful in identifying PD.

Aged↗
PubMed2006

Improvement in colour vision parameters following successful trabeculectomy.

PURPOSE: To determine whether colour vision improves following reduction of intraocular pressure (IOP) in glaucoma patients. METHODS: The medical records of 29 glaucoma patients (41 eyes) were reviewed. Inclusion criteria required subjects to have made more than four visits to the Glaucoma Service Laboratory and to undergo a thorough eye examination including a Farnsworth-Munsell 100-hue colour vision test and Goldmann tonometry before and after pressure lowering. Colour vision parameters of total error score (TES), yellow-blue score (YBS) and red-green score (RGS) were measured. The study group consisted of 21 eyes of glaucoma patients who underwent uncomplicated trabeculectomy with an IOP reduction of >/= 20% from baseline. The control group consisted of 21 eyes of glaucoma patients matched for age and colour vision, who received medication and/or underwent surgery with a post-intervention IOP reduction of < 20% from baseline. The primary outcome was a comparison of pre- and post-intervention colour vision parameters between the two groups. RESULTS: There was a statistically significant improvement in TES (43 +/- 44, p < 0.001), RGS (19 +/- 27, p = 0.0077) and YBS (23 +/- 29, p = 0.0007) in the study group compared with the control group. The improvement in TES (r = 0.52, p < 0.001), RGS (r = 0.55, p < 0.001) and YBS (r = 0.40, p = 0.008) was correlated with the percentage of IOP reduction. There was no statistically significant difference between improvement in Y-B and R-G scores in the study group. CONCLUSION: Intraocular pressure reduction of >/= 20% post-trabeculectomy was associated with an improvement in colour vision. Colour vision tests may be useful as an adjunctive outcome measure for therapeutic interventions.

Case-Control Studies↗
PubMed2003

The performance of color deficient individuals on airfield color tasks.

BACKGROUND: The pseudo-isochromatic plate (PIP) test (e.g., Ishihara test) is the clinical test commonly used to assess color vision. Upon failure of this test, candidates are typically reassessed using the Farnsworth Lantern (FALANT) test to determine their fitness for occupations which require normal color vision. We were interested in determining to what extent clinical tests can predict real life color naming performance, particularly in the context of "airside drivers" (any airport vehicle operators who drive on the airfield). METHODS: There were 24 male subjects with a color vision deficiency, as defined by the Ishihara test, who participated in this study. They were further assessed using the D-15 and lantern color vision tests. All subjects then participated in two separate color naming tasks. These tasks consisted of naming surface colors and colored-lights of the type used on the airfield of the Hong Kong International Airport (HKIA). RESULTS: Of the 24 subjects, 15 failed both D-15 and the FALANT tests. Out of these 15 subjects, 8 also failed the naming tasks. The FALANT test showed very good agreement (87.5%) with the Ishihara test. Similar to the Ishihara, FALANT tests had 100% sensitivity in identifying the subjects who failed the naming tasks. The agreement between the Ishihara and D-15 tests was 62.5%. DISCUSSION: In common with previous studies, our results show that clinical tests cannot predict accurately who will fail color naming tasks of the type normally encountered in the real-life work environment. The high false positive values of the clinical tests in relation to color naming tasks suggest that people with color deficiency may not be given a fair opportunity to demonstrate their true ability in performing the task.

Adult↗
PubMed1979

Clinical implications of color vision research.

The attributes of color and the mechanisms underlying normal and defective color vision are reviewed. The clinical implications of some research efforts bearing on congenital and acquired color defects, peripheral color vision, and the influence of photostable pigments on color vision and color vision tests is presented. This presentation is intended to illustrate how selected avenues of research have contributed to our understanding of color vision and to demonstrate the clinical utility of that research.

Color Perception↗
PubMed1988

Color vision defects in ocular hypertension and glaucoma. Quantification with a computer-driven color television system.

In order to detect early defects of color vision caused by increased intraocular pressure, a computer graphics device and color monitor system were used to measure color contrast sensitivity. The system determines the threshold chrominance of a colored grating in which there is no change in luminance. The study included 13 control subjects aged 10 to 57 years and 19 patients with ocular hypertension or glaucoma aged 20 to 58 years. In the 13 eyes with visual field loss, color contrast sensitivity was profoundly reduced when the grating colors fell on a tritan color confusion line. In the eyes without visual field loss, tritan color contrast sensitivity was reduced to an average level considerably below the extreme limits of the control group. These results were compared with those of other color vision tests and diagnostic criteria for glaucoma. The findings suggest that among the tests used, color contrast sensitivity testing was able to discriminate most effectively between patients who had retinal damage and the normal population.

Color Perception Tests↗
PubMed1991

Colour contrast sensitivity changes caused by peripheral retinal laser photocoagulation.

Macular phototoxicity is known to occur with laser use, and there is evidence that the wavelength of the light used influences this effect. In this study, a computer based colour contrast sensitivity test was used to assess the immediate macular effects of photocoagulation of peripheral flat retinal holes in otherwise normal retinas, using blue-green (488 and 514 nm), yellow (577 nm), orange (595 nm) or red (647 nm) laser light. The laser aiming beam was not allowed to traverse the macula at any stage during treatment. No protan or deutan axis threshold changes were noted in the 17 patients tested irrespective of the laser wavelength used. Tritan axis sensitivity was significantly reduced one hour after treatment with the blue-green laser, but no tritan axis change was found after treatment with longer wavelength lasers. The effect was no longer present the day after treatment in the subjects tested. The results show that even peripheral retinal treatment with blue-green laser can cause acute macular phototoxicity.

Color Perception↗
PubMed1997

Chromatic-contrast threshold impairment in diabetes.

A prospective study was carried out to investigate acquired colour-vision deficits in diabetics using an automated, computer-controlled, cathode-ray-tube based test of chromatic contrast. Chromatic-contrast thresholds estimates were measured along both a red/ green (constant S-cone) confusion axis and a tritan (constant M/L-cone) confusion axis for 305 eyes of 305 diabetics. The diabetic data were partitioned into groups based on a clinical categorisation of retinopathy. The diabetic data were compared with both age-matched and 'lens-equated' control data obtained from a bank of 347 normal subjects. Further analysis of differences between diabetic-status groups was performed. Associations between chromatic contrast threshold estimates and age, duration of disease, and severity of both macular oedema and ischaemia were investigated. The diabetic group was found to have significantly reduced chromatic-contrast threshold estimates when compared with normal controls, even in the absence of retinopathy. This reduction in chromatic contrast was predominantly tritanopic in nature. Interestingly, no reduction in red/green chromatic-contrast threshold estimate was found in diabetics without retinopathy. The tritan deficit seen in diabetics without retinopathy was strongly correlated with duration of disease, but when adjustments were made to account for the effects of duration-dependent lens yellowing, the tritan deficit was no longer apparent. A correlation between both the severity of macular oedema and severity of ischaemia with chromatic-contrast loss was established. Acquired reductions in both red/green and tritan chromatic-contrast threshold estimates seen in diabetics are strongly correlated with the severity of retinopathy. The results provide evidence that the specific tritan deficits seen in diabetics can be explained by the effects of lens yellowing rather than by selective damage of the blue cone system as has been hypothesised by other groups. The results provide support for the potential use of automated CRT-based tests of colour vision in diabetic retinopathy screening protocols.

Adolescent↗
PubMed1988

A new test for screening color vision: concurrent validity and utility.

Recognizing the need for an effective test for screening color vision in young children, we have developed a new pseudoisochromatic (PIC) plate test which is useful for a wide variety of observers at different ages. The test consists of four plates and responses can be used to categorize color vision as normal or as either red-green or blue-yellow defective. Results of this validation study with adults, both color normal and red-green defective, show a high degree of correlation between the new test and the Nagel anomaloscope: there were no false positives and only a few false negatives, which occurred with mild deuteranomalous observers. The validity of the test compares favorably to the Ishihara, F-2, and the AO-HRR screening plates. Results with toddlers (3 to 6 years) indicate that the task demands of the test are well suited for testing young children. The percentage of color defectives identified in the toddler sample using the new test is closer to the adult prevalence than results obtained with the F-2 and AO-HRR screening plates, which gave dramatically higher failure rates. The new test is culture-free and can be administered rapidly to both verbal and nonverbal observers using pointing or preferential looking.

Adult↗
PubMed1993

Colour vision screening in children: an evaluation of three pseudoisochromatic tests.

We examined 513 children (258 boys and 255 girls), between 3 and 11 years of age, with three pseudoisochromatic tests which involve different visual tasks. These were a selection of numeral designs from the Ishihara test, the Ishihara test for Unlettered Persons and the Velhagen Pfügertrident test. Eighteen children were found to be colour deficient. The symbol designs of the Unlettered Persons test were found to be the quickest and most effective method for examining children under 7 years of age. After 7 years of age the symbol designs of the Unlettered test and the numeral designs of Ishihara test were equally effective. The preferred numeral designs for screening children with the Ishihara plates are listed. Verbal identification always produced the most accurate results. Drawing over the figures or selecting replicas increased the viewing time and assisted children with normal colour vision to see both figures in transformation designs, especially pathway designs. The Velhagen Pfügertrident test was found to be unreliable for colour vision screening and younger children had difficulty performing the figure matching task.

Age Factors↗
PubMedDate not supplied

Abnormal color vision and reliable self-monitoring of blood glucose.

Color vision was assessed in 103 insulin-dependent diabetic patients using the Farnsworth-Münsell 100-Hue Test. All showed color vision impairment. Thirty-four had true dyschromatopsia while 22 suffered from tritanopia or other axial defects. We evaluated how accurately diabetic patients could monitor their own blood glucose by asking them to read a series of 30 precalibrated BM Test Glycemic Strips (Chemstrip, Boehringer, Mannheim, West Germany) without a meter. Patients with axial defects performed least well regardless of 100-Hue scores. Reading accuracy of patients with no axial defects was strongly correlated to 100-Hue scores, although patients having dyschromatopsia were consistently hesitant about their readings. Our results suggest that self-monitoring of blood glucose without a meter is indicated only after color vision has been examined by the 100-Hue Test. Self-monitoring should be voided with patients suffering from axial defects or having unsatisfactory 100-Hue scores.

Adult↗