Color vision deficiency in preschool children: the multi-ethnic pediatric eye disease study
John Z Xie1, Kristina Tarczy-Hornoch2, Jesse Lin3
1Gavin Herbert Eye Institute, University of California, Irvine, Irvine, California; Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California.
Insights
Color vision deficiency (CVD) prevalence in preschool boys varies significantly by ethnicity, with non-Hispanic white boys most affected. Testability for CVD testing is high by age four.
Area of Science:
- Ophthalmology
- Pediatrics
- Genetics
Background:
- Color vision deficiency (CVD) affects a significant portion of the population, with varying prevalence across ethnic groups.
- Early identification of CVD in children is crucial for educational and developmental support.
- Understanding sex- and ethnicity-specific prevalence informs targeted screening and intervention strategies.
Purpose of the Study:
- To determine the sex- and ethnicity-specific prevalence of color vision deficiency (CVD) in preschool children.
- To analyze CVD prevalence across Black, Asian, Hispanic, and non-Hispanic White ethnic groups.
- To assess the testability of color vision screening in young children.
Main Methods:
- A population-based, cross-sectional study involving 4177 preschool children (30-72 months).
- Color vision testing utilized 'Color Vision Testing Made Easy' and confirmed with the 'Waggoner HRR Diagnostic Test'.
- Data stratified by age, sex, and ethnicity to determine CVD prevalence and testability.
Main Results:
- Testability for color vision screening increased with age, reaching 98% in children aged 61-72 months.
- Prevalence of CVD in boys was 1.4% (Black), 3.1% (Asian), 2.6% (Hispanic), and 5.6% (non-Hispanic White).
- Prevalence in girls was minimal (<0.5%) across all ethnicities; statistically significant ethnic differences were observed in boys.
Conclusions:
- Color vision testing is highly feasible in preschool children by age four.
- Significant ethnic variations in CVD prevalence exist among preschool boys.
- Non-Hispanic White boys exhibited the highest CVD prevalence, while Black boys had the lowest.
Purpose:
To determine the sex- and ethnicity-specific prevalence of color vision deficiency (CVD) in black, Asian, Hispanic, and non-Hispanic white preschool children.
Design:
Population-based, cross-sectional study.
Participants:
The Multi-Ethnic Pediatric Eye Disease Study is a population-based evaluation of the prevalence of vision disorders in children in Southern California. A total of 5960 subjects 30 to 72 months of age were recruited for the study, of whom 4177 were able to complete color vision testing (1265 black, 812 Asian, 1280 Hispanic, and 820 non-Hispanic white).
Methods:
Color vision testing was performed using Color Vision Testing Made Easy color plates (Home Vision Care, Gulf Breeze, FL), and diagnostic confirmatory testing was performed using the Waggoner HRR Diagnostic Test color plates (Home Vision Care).
Main Outcome Measures:
Testability of color vision in preschool children between 30 and 72 months of age and prevalence of CVD stratified by age, sex, and ethnicity.
Results:
Testability was 17% in children younger than 37 months of age, increasing to 57% in children 37 to 48 months of age, 89% in children 49 to 60 months of age, and 98% in children 61 to 72 months of age. The prevalence of CVD among boys was 1.4% for black, 3.1% for Asian, 2.6% for Hispanic, and 5.6% for non-Hispanic white children; the prevalence in girls was 0.0% to 0.5% for all ethnicities. The ethnic difference in CVD was statistically significant between black and non-Hispanic white children (P = 0.0003) and between Hispanic and non-Hispanic white children (P = 0.02). In boys, most CVD cases were either deutan (51%) or protan (34%); 32% were classified as mild, 15% as moderate, and 41% as severe.
Conclusions:
Testability for CVD in preschool children is high by 4 years of age. The prevalence of CVD in preschool boys varies by ethnicity, with the highest prevalence in non-Hispanic white and lowest in black children.
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