A Performance Comparison of Color Vision Tests for Military Screening

Area of Science:

• Ophthalmology
• Human Factors
• Military Medicine

Background:

• Current U.S. Army aviation color vision (CV) screening tests yield only pass-fail results.
• Previous studies indicate variable sensitivity and specificity of existing CV screening methods.
• A need exists for an optimized CV screening test for U.S. Army aviation personnel.

Purpose of the Study:

• To evaluate seven different color vision tests for aviation screening.
• To identify an optimal CV test for potential implementation by the U.S. Army.
• To compare test performance against established criteria and administration efficiency.

Main Methods:

• 133 subjects (65 with Color Vision Deficits (CVD), 68 Color Vision Normal (CVN)) participated.
• Initial CVD/CVN assessment used the Oculus anomaloscope as the gold standard.
• Tests were administered monocularly; sensitivity, specificity, and administration time (for automated tests) were primary outcomes.

Main Results:

• Three Pseudoisochromatic Plate (PIP) tests and the Cone Contrast Test (CCT) achieved sensitivity/specificity > 0.90.
• FALANT tests showed sensitivity/specificity > 0.80, and the Color Assessment and Diagnosis (CAD) test > 0.85.
• CCT, Dvorine PIP, and PIPC tests demonstrated no significant difference in sensitivity/specificity compared to the anomaloscope; CCT was faster than CAD.

Conclusions:

• Current U.S. Army CV screening tests, along with automated options like CCT, exhibit good sensitivity and specificity.
• The CCT, Dvorine PIP, and PIPC tests are statistically comparable to the anomaloscope for aviation screening.
• The CCT's randomized presentation minimizes memorization or fading biases inherent in some plate tests.