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Observations on color vision testing in ocular hypertension and glaucoma.

Forty-eight patients aged from 60 to 69 years (58 eyes) with ocular hypertension (OHT) or primary open angle glaucoma (POAG) and a control group of 16 persons (31 eyes) were studied with six color vision tests: Standard Pseudoisochromatic Plates Part 2, Farnsworth Panel D 15, Farnsworth-Munsell 100-hue (FM 100) test, Lanthony Desaturated Panel, Nagel (red-green) anomaloscope, and Besançon (blue) anomalometer. In the color vision tests, the newly diagnosed OHT eyes without treatment differed significantly from the control group in the blue anomalometer. The long-term OHT eyes with treatment had no significant difference from the normals in any of the tests. The newly diagnosed POAG eyes without treatment were significantly different from the normals in the FM 100 test as well as in the boxes I, II, III and IV of the test, in the Lanthony Desaturated Panel and in the blue anomalometer. The long-term POAG eyes with treatment only differed significantly from the normal eyes in the blue anomalometer. The box IV of the FM 100 test and blue anomalometer were observed to be the most useful of these six tests in finding the possible early beginning of the blue color vision defect in the group of newly diagnosed OHT.

Aged

Lanthony's new color test. II. Clinical evaluation.

The desaturated 15 Hue test is estimated to give about 7% false-positive single protanopic confusions. Confusions between tetartanopic and protanopic directions are not infrequent. The New Color Test findings, in general, reflect the AOH-R-R pathology but, among other things, because of the difference in their size, the classifications of both tests should not be compared. The New Color Test proves to be valuable, and can be easily employed in a routine clinical procedure. An examination scheme is proposed.

Color Perception Tests

[A railway accident a hundred years ago as reason for systematic testing of colour vision (author's transl)].

Holmgren's supposition that colour blindness was one of the causes for the train-disaster which happened on 15th November 1875 near Lagerlunda had been passed on as an established fact. The course of the accident is outlined on the basis of the court records. It shows that not colour blindness, but the fact that the engine-driver and the station-master were acting contrary to regulations resulted in the head-on collision with the opposite train. After this event systematic testing of colour vision in railway-men was instituted and the methods of examination were considerably improved.

Accidents, Traffic

Color vision screening and viewing conditions: the problem of misdiagnosis.

The most popular techniques for assessing color vision, the pseudoisochromatic tests, have been found to differ widely in their sensitivity to changes in viewing conditions. A significant number of color-normal subjects will be misdiagnosed as color defective by some of the standard tests with even relatively minor variations from standardized viewing conditions. These results appear to have strong implications for the use of the tests in many applied settings which precise control over viewing conditions is difficult. In particular, as the consequences of a misdiagnosis become very serious, the tests must be used with special caution. If we were to recommend one test for use, our findings point to the Ishihara, which appears impervious to variation in viewing conditions.

Color Perception Tests

Colour vision of diabetics.

The Farnsworth-Munsell 100-hue test has been assessed as a screening test for the detection of diabetic retinopathy likely to benefit from laser photocoagulation therapy. Two hundred and thirty-two diabetic eyes of 126 patients were tested. The results were assessed both for total error score relative to age and for the presence of polarity. Although the incidence of abnormal colour discrimination was found to correlate with the severity of retinopathy, the test was not sufficiently selective to be of value as a screening test in the detection of retinopathy requiring treatment.

Aged

The Davidson and Hemmendinger color rule as a color vision screening test.

The Davidson and Hemmendinger (DH) color rule was evaluated for color vision screening of normal and congenital color-defective subjects. Ninety-eight normal and 14 color-defective subjects were tested on the color rule under Macbeth illumination of 5,400 K. The color-defective subjects were also tested on the Nagel anomaloscope, the Farnsworth D-15, and the H-R-R pseudoisochromatic plates. The DH color rule performed as accurately as the anomaloscope and was superior to the other two tests in detecting anomalous trichromats and in discriminating protanomalous subjects. The color rule also discriminated dichromats from anomalous trichromats. For severe color-defective subjects (dichromats, achromats), the color rule was more time-consuming than the other tests and discrimination was less certain. Response patterns on the DH color rule and response variability of the different classifications are reported.

Adolescent

Berson test for blue cone monochromatism.

The Berson test for blue cone monochromatism discriminates X-linked blue cone monochromatism from achromatopsia but not from X-linked progressive c dystrophy.

Color Perception Tests

Color vision testing for the U.S. Naval Academy.

Normal color vision is a prerequisite for admission to the United States Naval Academy. The Farnsworth Lantern (FALANT) is the Navy's definitive test for color vision. A FALANT is not available at many locations where candidates are examined, so satisfactory performance on pseudoisochromatic plates has been considered an acceptable alternative. Until recently, the Farnsworth Dichotomous Test Panel D-15 had also been used as an alternative test, but is now considered unacceptable. In the summer of 1991, a large number of candidates reported for induction who were unable to pass the FALANT. Since their screening physical examinations had been reported to show normal color vision, a shadow of doubt was cast upon the ability of the alternative tests to predict performance on the FALANT. Four hundred subjects were then tested on several color vision tests to determine if these tests could predict FALANT success. The results of this study and recommendations are presented.

Adolescent

Contrast/color card procedure: a new test of young infants' color vision.

We have developed a new test which can rapidly evaluate basic color vision in individual infants. The test consists of a series of large cards constructed with Munsell Hues. It uses a modified preferential looking procedure (FPL) and, to control brightness cues, incorporates a two-phase systematic variation of luminance. First, we evaluate an infant's ability to discriminate 9.5 by 16 degrees achromatic patches of varying luminance from a 26 by 65 degrees achromatic background of midrange luminance. In the second phase the test patch is chromatic and its luminance, relative to the background, is varied over a range of about 1.0 log cd/m2. The number of relative luminances chosen for each infant depends upon his/her performance in phase 1. Seventy 2- and 3-month-olds were tested with 4 broad-band chromatic patches, a red (dominant lambda = 660 nm), a yellow (dominant lambda = 580 nm), a green (dominant lambda = 520 nm), and a blue (dominant lambda = 475 nm). Results showed that 3-month-olds had little difficulty making any of the chromatic-achromatic discriminations but many 2-month-olds appeared to fail to discriminate the yellow and green from the background at relative luminances close to an adult brightness match. Most importantly, the test shows promise as a relatively simple, time-efficient, and portable tool for the assessment of early color vision.

Color Perception Tests

Acquired 'tritan' deficiencies in macular pathology.

14 patients with maculopathy (18 eyes affected, 10 eyes clinically normal) were examined using the HRR plates, the Farnsworth F2 (tritan) plate, the Farnsworth panel D15 test, the Nagel anomaloscope (model I) and on a 'blue-green' equation for 2 degrees and 11 degrees fields on the Moreland anomaloscope. The correlation of tritan-like responses to each test and the differences between the 2 degrees and 11 degrees equations are discussed.

Adult

Colorimetry by a new principle.

A simple and informative method is described for determining the type and extent of color defects. The subjects' responses are registered automatically on a chromaticity diagram that is based on the newtonian model. Color defects are readily identifiable by a skewing of the normal central gray area toward the defectively perceived color. The examination permits independent variation of hue and saturation for each color and requires less than five minutes for the entire procedure. Unlike conventional color tests, the present method indicates exactly what colors are or are not seen at any level of saturation.

Adolescent

Ability of deutan color defectives to perform simulated air traffic control tasks.

Air traffic controllers perform a variety of tasks which require them to identify, discriminate, and name colors. Qualification standards for this occupation require applicants and incumbents to have normal color vision. The validity of this standard has been questioned and is currently under review. In this study, 22 deutans and 78 normals were tested on a set of tasks which simulated critical tasks performed daily by air traffic controllers. The four tasks included discriminating red from black pencil marks on flight progress strips, color-naming of 1 degree and 0.1 degree discs, and identification of colored line segments embedded in a multicolored background. Deutans classified as mild were found to perform all tasks as well as normals. Moderate deutans performed only the large disc color-naming task as well as normals, whereas severe deutans performed none of the tasks as well as normals. Different methods for scoring the color vision tests were explored to determine their value as predictors of task performance. The D-15 relative error score was found to be the single best predictor of performance on the tasks (r-square = 0.602). It is concluded that mild deutan color defectives have adequate color vision for safe performance of several critical air traffic control tasks. Moderate and severe deutans do not. In addition, the results of several methods for scoring color vision tests can be used to predict group, but not individual, performance with high reliability.

Aviation

[The Ohkuma's test: an evaluation].

Ohkuma's pseudoisochromatic test was evaluated in 147 subjects including 130 cases with hereditary dyschromatopsias, and compared with the color vision tests of Ishihara, the HRR, the Farnsworth Panel D-15 and the City University Color Vision Test. Qualitatively, Ohkuma's test was more exact for the diagnosis of the axis of the dyschromatopsia (protan or deutan); quantitatively, Ohkuma's test was of good efficiency for screening, but the quantitative gradation was mediocre, indicating dichromatism in only 3/4 of the cases.

Adolescent

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

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

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