color vision testing Blais, Bernard

1. Color Vision Testing Bernard R. Blais, M.D. Clinical Professor Albany Medical College Albany, New York Blais Consulting, Ltd. 4 Innisbrook Drive Clifton Park, NY 12065 Phone: (518) 371-8147 Fax: (518) 373-9347 Email: bblais@nycap.rr.com Disclosure: Book Royalty Publisher New Color Vision Book, RPI Publishers, Atlanta, GA

2. Who is doing color vision testing?

6. Who is using the Ishihara Plates for testing color deficiencies? What is it testing?

7. Who utilizes the color vision testing in the Titmus Equipment Stereo Optical Equipment Armed Forces Screening

8. What color test is utilized?

11. Does color defect really cause a difference? Websafe selection. The 27 normal colours have been produced by all combinations of 0, 50, and 100% levels of red, green and blue primaries. They have then been transformed to show their appearance to colour-blind viewers. McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002 Figure 30.

16. So what does one actually see with each of these deficiencies?

17. Color normal Blue blind

18. Color normal Green blind

19. Color normal Red blind

20. Websafe selection. The 27 normal colours have been produced by all combinations of 0, 50, and 100% levels of red, green and blue primaries. They have then been transformed to show their appearance to colour-blind viewers. McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002 Figure 30.

21. Websafe selection. The 27 normal colours have been produced by all combinations of 0, 50, and 100% levels of red, green and blue primaries. They have then been transformed to show their appearance to colour-blind viewers. McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002 Figure 30.

22. Websafe selection. The 27 normal colours have been produced by all combinations of 0, 50, and 100% levels of red, green and blue primaries. They have then been transformed to show their appearance to colour-blind viewers. McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002 Figure 30.

23. How does this affect the individual’s ability?

24. Another example of how color might appear with normal color vision on the left, and the same objects as they might appear with a color deficiency on the right.

25. Traffic lights as seen with normal color vision on the left and, as they might appear with some types of color vision deficiency on the right.

26. The Nomenclature of Color Vision Deficiencies Table I Incidence of Color Defects in Caucasian Males Heredity % (1) Trichromatism (a) normal 91.8 (b) anomalous - (i) protanomaly 1.0 (ii) deuteranomaly 4.6 (iii) tritanomaly 0.0001 (2) Dichromatism (a) protanopia 1.2 (b) deuteranopia 1.4 (c) tritanopia 0.0001 (3) Monochromatism (a) of the rods 0.003 (b) of the cones 0.000001 Acquired (a) triton (blue-yellow) possibly 5% (b) proton (red-green) Duke Elder, S., Gloster, J. Weale, R. Physiology of The Eye, Chapter XVI on Color Vision, page 616, 1968 Table XIV and Birch, Jennifer, Diagnosis of defective color vision, Oxford University Press (1993).

29. Available Color Vision Testing Techniques 10 min. 10 min. 6000 Classify and grade red-green defects Rarely used Anomaloscope (Nagel) Prototypes Not standardized to requirements. Prototype under under develop- development. ment. Computer-Based Tests <5 min. 1 hour >10 min. < 5 min. PATIENT TIME Test occupational requirement Discrimination Discrimination Severity INDICATION < 5 min. <500 Widely used Pseudoisochromatic Plate <5 min. 3000 Used in screening persons for RG Standard test Lantern (Falant) 1 hour >10 min. 900 350 Very selective Medical Research Arrangement Test – Hues FM 100 D 15 TECH TIME EQUIPMENT COST FREQUENCY USED

30. Available Color Vision Testing Techniques R.G. No Optical equipment Anomaloscope (Nagel) R.G.B Yes Plate of irregular dots Pseudoisochromatic Plate Not standardized to requirements. Prototype under development. Computer-Based Tests R.G.White Yes One to three lights Lantern (Falant) R.G.B. Identify moderate Severe capabilities Classify R.G.B. abnormalities Yes No No Color disks (caps) 100 15 Arrangement Test – Hues FM 100 D 15 GRADING TESTS SCREENER DESIGN

32. Available Color Vision Testing Techniques 10 min. 10 min. 600 Classify and grade red-green defects Rarely used Anomaloscope (Nagel) Prototypes Not standardized to requirements. Prototype under under develop- development. ment. Computer-Based Tests <5 min. 1 hour >10 min. < 5 min. PATIENT TIME Test occupational requirement Discrimination Discrimination Severity INDICATION < 5 min. <500 Widely used Pseudoisochromatic Plate <5 min. 3000 Used in screening persons for RG Standard test Lantern (Falant) 1 hour >10 min. 900 350 Very selective Medical Research Arrangement Test – Hues FM 100 D 15 TECH TIME EQUIPMENT COST FREQUENCY USED

34. Available Color Vision Testing Techniques R.G No Optical equipment Anomaloscope (Nagel) R.G.B Yes Plate of irregular dots Pseudoisochromatic Plate Not standardized to requirements. Prototype under development. Computer-Based Tests R.G.White Yes One to three lights Lantern (Falant) R.G.B. Identify moderate Severe capabilities Classify R.G.B. abnormalities Yes No No Color disks (caps) 100 15 Arrangement Test – Hues FM 100 D 15 GRADING TESTS SCREENER DESIGN

36. Available Color Vision Testing Techniques 10 min. 10 min. 6000 Classify and grade red-green defects Rarely used Anomaloscope (Nagel) Prototypes Not standardized to requirements. Prototype under under develop- development. ment. Computer-Based Tests <5 min. 1 hour >10 min. < 5 min. PATIENT TIME Test occupational requirement Discrimination Discrimination Severity INDICATION < 5 min. <500 Widely used Pseudoisochromatic Plate <5 min. 3000 Used in screening persons for RG Standard test Lantern (Falant) 1 hour >10 min. 900 350 Very selective Medical Research Arrangement Test – Hues FM 100 D 15 TECH TIME EQUIPMENT COST FREQUENCY USED

37. Available Color Vision Testing Techniques R.G. No Optical equipment Anomaloscope (Nagel) R.G.B Yes Plate of irregular dots Pseudoisochromatic Plate Not standardized to requirements. Prototype under development. Computer-Based Tests R.G.White Yes One to three lights Lantern (Falant) R.G.B. Identify moderate Severe capabilities Classify R.G.B. abnormalities Yes No No Color disks (caps) 100 15 Arrangement Test – Hues FM 100 D 15 GRADING TESTS SCREENER DESIGN

39. Available Color Vision Testing Techniques 10 min. 10 min. 6000 Classify and grade red-green defects Rarely used Anomaloscope (Nagel) Prototypes Not standardized to requirements. Prototype under under develop- development. ment. Computer-Based Tests <5 min. 1 hour >10 min.. < 5 min. PATIENT TIME Test occupational requirement Discrimination Discrimination Severity INDICATION < 5 min. <500 Widely used Pseudoisochromatic Plate <5 min. 3000 Used in screening persons for RG Standard test Lantern (Falant) 1 hour >10 min. 900 350 Very selective Medical Research Arrangement Test – Hues FM 100 D 15 TECH TIME EQUIPMENT COST FREQUENCY USED

40. Available Color Vision Testing Techniques R.G. No Optical equipment Anomaloscope (Nagel) R.G.B Yes Plate of irregular dots Pseudoisochromatic Plate Not standardized to requirements. Prototype under development. Computer-Based Tests R.G.White Yes One to three lights Lantern (Falant) R.G.B. Identify moderate Severe capabilities Classify R.G.B. abnormalities Yes No No Color disks (caps) 100 15 Arrangement Test – Hues FM 100 D 15 GRADING TESTS SCREENER DESIGN

42. Available Color Vision Testing Techniques 10 min. 10 min. 6000 Classify and grade red-green defects Rarely used Anomaloscope (Nagel) Prototypes Not standardized to requirements. Prototype under under develop- development. ment. Computer-Based Tests <5 min. 1 hour >10 min. < 5 min. PATIENT TIME Test occupational requirement Discrimination Discrimination Severity INDICATION < 5 min. <500 Widely used Pseudoisochromatic Plate <5 min. 3000 Used in screening persons for RG Standard test Lantern (Falant) 1 hour >10 min. 900 350 Very selective Medical Research Arrangement Test – Hues FM 100 D 15 TECH TIME EQUIPMENT COST FREQUENCY USED

43. Available Color Vision Testing Techniques R.G. No Optical equipment Anomaloscope (Nagel) R.G.B Yes Plate of irregular dots Pseudoisochromatic Plate Not standardized to requirements. Prototype under development. Computer-Based Tests R.G.White Yes One to three lights Lantern (Falant) R.G.B. Identify moderate Severe capabilities Classify R.G.B. abnormalities Yes No No Color disks (caps) 100 15 Arrangement Test – Hues FM 100 D 15 GRADING TESTS SCREENER DESIGN

47. What test fulfills these requirements? The function of different types of color vision tests Classification and Screening tests grading tests Diagnostic tests Vocational tests 1. Anomaloscopes 1. Anomaloscopes 1. Anomaloscopes and psychophysical tests 2. Pseudoisochromatic 2. Some pseudo- plates isochromatic plates 3. Hue discrimination 1. Hue discrimination (or arrangement) tests (or arrangement) tests 2. Lanterns

56. HRR Diagnosis of Color Deficiency Diagnosis based on HRR results Type HRR Extent: Passes Screener Mild Medium Strong Frequency Protan Minimal Affect Anomalous Anomalous Protanope 25% Protan Protan Deutan Minimal Affect Anomalous Anomalous Deuteranope 75% Deutan Deutan Tritan Minimal Affect Anomalous Anomalous Trianope trace Comparison with Color Chip tests Farnsworth D15 Passes Passes Fails Fails N/A L’Anthony D15 Passes Fails Fails Fails N/A Informational Brochures of Richmond Products Resources 2007.

58. Tests used for evaluation of congenital color deficiency (modified) Function Scope Tests Screening red-green defects Ishihara plates blue defects CU (City University) tritan plates HRR plates Screening & grading Ishihara + CU tritan plates HRR plates D15 test, Anomaloscope Evaluation D15, FM100 Anomaloscope Occupational transport & armed Ishihara plates screening services Falant McIntyre, D, Color Blindness Causes and Effects, Dalton Publishing, Chester, England, 2002, p. 81.

60. Do you want your employees having the “activities of daily living” working with these defects?

61. What do you want the employees to see where color vision is a mandatory requirement?

62. B. Red-Blind A. Color Normal Fruit stall. A fruit stall as seen by a color normal (A) and red-blind (B). McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002. Figure 32.

63. C. Green-Blind A. Color Normal Fruit stall. A fruit stall as seen by a color normal (A) and green-blind (C). McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002. Figure 32.

64. D. Blue-Blind A. Color Normal Fruit stall. A fruit stall as seen by a color normal (A) and blue-blind (D). McIntyre, D., Color Blindness Causes and Effects, Dalton Publishing, Chester England, 2002. Figure 32.

65. Dr. Maureen Neitz