COLOR BLINDNESS:

ASSESSMENT AND
CORRECTION

STUDENT : HUYNH NGOC HOANG NGAN

SUPERVISOR: TRAN HOAI LONG MOPTOM
OPHTHALMOLOGY DEPARTMENT - OPTOMETRY SUB-DEPARTMENT
PHAM NGOC THACH MEDICAL UNIVERSITY
 INTRODUCTION

 Color vision Deficiencies (CVD) : 4,5% of the population (Pokorny et al.,

1979) 1
 Patient not aware of their status unitl they got screening.
 However one fifth to one third of adult abnormal color vision patient are
not noted of their status 2
 Not all optometrists do the exam in their clinical rotation.
-> Because no specific can cover all information about the kind of CVD.

1. Schwartz, S.,2004, 4,93-168

2. Cole, B. ,2007, 90, 157-175.
 Method
 This review is introducing some designs of some
color vision tests and methods enhancing color
perception
 Method: Literature review. Primary review from
English articles from Pubmed and English books of
topic Color vision assessment and correcting
 BACKGROUND
INTRODUCTION OF COLOR VISION
 Normal Humans able to perceive a wavelength of light a
range from about 380 nm to 700 nm.1
 Normal color vision is trichromatic
 Trichromatic theory of color: stated that three mechanisms
with sensitivities in different portion of electromagnetic
spectrum decide human color perception. 2

1. Schwartz, S,2004,4,93-168
2. Almutairi, Nawaf; Kundart, James; Muthuramalingam, Naganathan; Hayes, John; Citek, Karl; and Aljohani, Saad,2017
 BACKGROUND
COLOR VISION ANOMALIES
Congenital colour vision deficiencies
 Achromatopsia : translated as without color, uncommon 1
 Dyschromatopsia includes Dichromacy and Trichromacy Anomalies

Basic classification of color vision anomalies.

(Schwazrt, S. ,2004)
1. Khurana, D. ,2007, 4,303-305
 BACKGROUND
COLOR VISION ANOMALIES

 Acquired color vision defects

Color Vision Anomalies Predicted By Köllner’s Rule.

Schwazrt, S.,2004
 TYPE OF ASSESSMENT FOR COLOR
VISION DEFICIENCY

Catergorize into :
Traditional design tests
Computerized tests
 Pseudoisochromatic plates (PIC tests)
Application to Stilling’s principle. 1

Ishihara test Richmond HRR test 2002

 One of the most efficiently tests to detect 4th edition
CVD using in industry and school testing
(Voke 1976a) 1 and in clinic  Re-designed edition of original AO HRR 2
 Good screening for red-green defects test  More sensitive at detecting color vision
2 anomalies than the old version. 3
 Disadvantage :determining type of CVD
and calculate the amount of severity. 3

1. Fletcher, R., & Voke, J. ,1985,1

2. National Research Council (US) Committee on Vision, 1981
3. Cole, B. ,2007,1985,90,157-175
 Arrangement Tests
Farnsworth Dichotomous Test for Color Blindness
(Farnsworth Panel D-15)

 Short and simple version of 100 Hue test 1

 Using for initial color assessment in clinical and special job assessment
1

 Based on the hue circle in CIE program 2

1. Cole, B. ,2007,1985,90,157-175 Score sheet of Farnsworth Panel D-15 test, with primary
2. National Research Council (US) Committee on Vision, 1981 confusion lines in hue circle.
(Schwazrt, S.,2004)
 Arrangement Tests
Lanthony Desaturated Panel

 Modified version of standard D-15 test.1

 Using lower chroma,less purify chip 2
 Useful in evaluating or detecting acquired
color vision losses in some eye diseases,
such as glaucoma (Adam et al., 1982) 3
or early screening for juvenile diabetes
(Cristiano Giusti,2001) 4

Hue circle from the chips of standard and desaturated D-15 on

1. Schwartz, S.,2004, 4,93-168
2. Lanthony, P. ,1978, 46, 185-189 CIE diagram.
3. Fletcher, R., & Voke, J. ,1985,1. (Schwarzt, S., 2004)
4. Giusti, C. ,2001.
 Arrangement Tests
Farnsworth–Munsell 100-Hue Test:

 Contains 85 color caps 1

 A quantitative diagnostic test 2
 Not a primary assessment, since it is time
–consuming -> A computerized version of
this test: a BASIC language
microcomputer program 3

Example of errors on the FM 100-hue test made by a normal

1. Fletcher, R., & Voke, J. ,1985,1
2. Rogošić, V., Bojić, L., Poljak, N., Duplančić, D., Vidan, P., Ivančić-Kačer, B., & trichromat.
Mulić, R. ,2012, 1, 69-76 (With The total errors of 40)
3. Coren, S. ,1986, 18, 323-324 (National Research Council (US) Committee on Vision, 1981)
 Nagel Anomaloscopes

 Classify between Dichromacy and Trichromacy Anomalies 1

 Standard instrument for diagnosis of red-green color vision
defects -> in research applied. 2
 2 types :
 Type 1: Based on Rayleigh’s equation (1881): Red+
Anomaloscope – User’s Manual, by
Green = Yellow 3 Hermann Krastel (2015), photograpgh,
retrieved from https://www.good-
 Type 2 : more common now, consists of “Moreland lite.com/cw3/Assets/documents/HMC
%20Anomaloscope%20User%20Guid
equation” to match blue-green to test tritan defects 3 4 e%20-%2012.16[1][2].pdf

1. Schwartz, S.,2004, 4,93-168

2. National Research Council (US) Committee on Vision, 1981
3. Fletcher, R., & Voke, J. ,1985,1
4. Rogošić, V., Bojić, L., Poljak, N., Duplančić, D., Vidan, P., Ivančić-Kačer, B., & Mulić, R. ,2012, 1, 69-76
 Computerized tests
Waggoner
Cambridge Colour Computerized
Test (CCT) Colour Vision Test
(Waggoner CCVT):

principle of Computerized
Chibret and Pseudoisochroma
Stilling. 1 tic plates test 3

Used as a
supporting Advantages:
diagnosis tool figure randomly
and monitoring appeared
1. Hasrod, N., & Rubin, A. ,2015 ,74
2. Paramei, G. ,2012,29 progression 2
3. Ng, J., Self, E., Vanston, J., Nguyen, A.,
& Crognale, M.,2015,92, 480-486
 Computerized tests

The Colour Assessment and

Diagnosis (CAD) Test:
color stimuli within an embedded
background of moving luminance
contrast noise. 1

Efficiency tool for red-green defects screening

1. Makunyane, P. ,2016, 22, 12-16
 Disscussion

 Clinical reasons : Ishihara and HRR is good

applications
 Computerized test :alternative for traditional one
with high sensitivity and specificity for red-green
CVD screening
 MANAGEMENT OF COLOR VISION
DEFECTS
 Acquired color vision defects : variable 1
 Congenital color vision defects: No method with complete
treatment yet.
 Red filter lens 2
 Notch filters: rule out a range of wavelength (545-575 nm) 3. An
Appliaction of notch filters is called Enchroma . 4

1. Fletcher, R., & Voke, J. ,1985,1

2. Schwartz, S.,2004, 4,93-168
3. Simunovic, M. ,2009, 24, 747-755.
4. Almutairi, Nawaf; Kundart, James;
Muthuramalingam, Naganathan; Hayes,
John; Citek, Karl; and Aljohani, Saad,2017
 MANAGEMENT OF COLOR VISION
DEFECTS
 Congenital color vision defects
 Genetic therapy : not yet applied to human
 Alexander et al. (2007) changing retinal structure and photoreceptor
mosaic of mouse subjects. 1
 In 2009 Mancuso et al. also had a trial research on missing
encoding L opsin gene adult squirrel monkeys 2

1. Simunovic, M. ,2009, 24, 747-755

2. Mancuso, K., Hauswirth, W., Li, Q., Connor, T., Kuchenbecker, J., & Mauck, M. et al. ,2009, 461, 784-787
 Conclusion

 There are number of selections in color vision tests with

different designs and functions available for optometrists
with both traditional and modern developments
 Optometrists is responsible mainly for primary eye care ->in
clinics: equipped with some simplex color vision tests.
 In the present there is no specific method or tool can
completely cure inherited color vision deficiency. Red filter
or Notch filter can be using to enhace color perception.
 Gene Therapy is a promising technology for treatment
 Acknowledgement

I would like to give a sincere gratitude to my beloved

supervisor, Mr. Long for his patient guidance, expert advices,
enthusiastic inspiration and valuable motivation, which help
me able to keep my work in schedule and finish this project.
I would also want to extend my special thanks to all the staff
members of Pham Ngoc Thach medical university optometry-
sub department, without their help and support, I would not be
able to succeed my work.
 References
Almutairi, Nawaf; Kundart, James; Muthuramalingam, Naganathan; Hayes, John;
Citek, Karl; and Aljohani, Saad (2017). Assessment of Enchroma Filter for
Correcting Color Vision Deficiency (Master’s Thesis ).Retrieved from
http://commons.pacificu.edu/opt/21
Cole, B. (2007). Assessment of inherited colour vision defects in clinical
practice. Clinical And Experimental Optometry, 90(3), 157-175. doi: 10.1111/j.1444-
0938.2007.00135.x
Coren, S. (1986). The Farnsworth-Munsell 100-hue test: A BASIC program for
scoring and analysis. Behavior Research Methods, Instruments, &
Computers, 18(3), 323-324. doi: 10.3758/bf03204408
Fletcher, R., & Voke, J. (1985). Defective colour vision: Fundamentals, Diagnosis
And Management (1st ed.). Bristol: A. Hilger Ltd.
Giusti, C. (2001). Lanthony 15-Hue Desaturated Test for Screening of Early Color
Vision Defects in Uncomplicated Juvenile Diabetes. Japanese Journal Of
Ophthalmology, 45(6), 607-611. doi: 10.1016/s0021-5155(01)00413-0
 References
Khurana, D. (2007). Comprehensive ophthalmology (4th ed., pp. 303-305). New
Delhi: New Age International (P) Limited.
Lanthony, P. (1978). The desaturated panel D-15. Documenta
Ophthalmologica, 46(1), 185-189. doi: 10.1007/bf00174107
Makunyane, P. (2016). An update on diagnostic tests for colour vision defects in
individuals working in the aviation industry. Occupational Health Southern
Africa, 22(3), 12-16. Retrieved from http://hdl.handle.net/2263/56527
Mancuso, K., Hauswirth, W., Li, Q., Connor, T., Kuchenbecker, J., & Mauck, M. et
al. (2009). Gene therapy for red–green colour blindness in adult
primates. Nature, 461(7265), 784-787. doi: 10.1038/nature08401
National Research Council (US) Committee on Vision. (1981). Procedures for
Testing Color Vision: Report of Working Group 41. Washington, DC: The National
Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK217818/
 References
Ng, J., Self, E., Vanston, J., Nguyen, A., & Crognale, M. (2015). Evaluation of the
Waggoner Computerized Color Vision Test. Optometry And Vision Science, 92(4),
480-486. doi: 10.1097/opx.0000000000000551
Paramei, G. (2012). Color discrimination across four life decades assessed by the
Cambridge Colour Test. Journal Of The Optical Society Of America A, 29(2), A293.
doi: 10.1364/josaa.29.00a293
Rogošić, V., Bojić, L., Poljak, N., Duplančić, D., Vidan, P., Ivančić-Kačer, B., &
Mulić, R. (2012). Comparative Analysis of Methods and Tests for Testing Colour
Vision of Professional Seafarers. Transactions On Maritime Science, 1(2), 69-76.
doi: 10.7225/toms.v01.n02.001
Schwartz, S. (2004). Visual Perception: A Clinical Orientation (4th ed., pp. 93-168).
OH, United States: The McGraw-Hill Companies, Inc.
Simunovic, M. (2009). Colour vision deficiency. Eye, 24(5), 747-755. doi:
10.1038/eye.2009.251