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Visualizing Visual Adaptation
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Clinical color vision testing and correlation with visual function.

Jiawei Zhao1, Sarita B Davé1, Jiangxia Wang1

  • 1Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

American Journal of Ophthalmology
|June 28, 2015
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Hardy-Rand-Rittler (H-R-R) and Ishihara tests do not accurately assess color vision in optic neuropathy. However, these tests correlate with contrast sensitivity and may serve as clinical surrogates.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Acquired visual dysfunctions, such as optic neuropathy, can impact color vision.
  • Accurate assessment of color vision is crucial for diagnosing and managing visual impairments.
  • Standardized tests like Hardy-Rand-Rittler (H-R-R), Ishihara, and Farnsworth D-15 (D-15) are used to evaluate color vision.

Purpose of the Study:

  • To evaluate the accuracy of H-R-R and Ishihara color vision tests in subjects with acquired visual dysfunction, specifically optic neuropathy.
  • To compare the performance of H-R-R and Ishihara tests against the Farnsworth D-15 (D-15) discs, considered the standard for color vision deficit detection.
  • To investigate the relationship between color vision test results and contrast sensitivity in this patient population.

Main Methods:

  • Prospective recruitment of 22 subjects with optic neuropathy and 18 healthy controls.
  • Exclusion criteria included visual acuity worse than 20/200 and congenital color blindness.
  • Comprehensive eye examinations included visual acuity, H-R-R plates, Ishihara plates, Farnsworth D-15 (D-15) discs, and Pelli-Robson contrast sensitivity charts.

Main Results:

  • No significant correlation was found between H-R-R or Ishihara test scores and D-15 scores (P = .477 and P = .973, respectively).
  • Both H-R-R and Ishihara test scores showed a positive correlation with contrast sensitivity (P = .003 and P < .001, respectively).
  • Multivariate analysis indicated that contrast sensitivity and visual acuity were associated with H-R-R scores, while contrast sensitivity was associated with Ishihara scores.

Conclusions:

  • H-R-R and Ishihara testing are not accurate for assessing color identification in patients with optic neuropathy.
  • Both H-R-R and Ishihara tests demonstrate a correlation with contrast sensitivity.
  • These tests may serve as useful clinical surrogates for contrast sensitivity testing in patients with optic neuropathy.