Case Report: Invalidation of the Farnsworth D15 Test in Dichromacy Secondary to Practice

The Farnsworth D15 test can be subverted by patients even with severe red-green color deficiency.

To describe a case showing that perfect performance on the Farnsworth D15 is possible after practicing the test.

A 23-year-old man presented for a comprehensive color vision evaluation. He had only minor complaints with regard to color vision and otherwise normal vision and ocular health. Based on anomaloscope findings, he was diagnosed with protanopia, a form of dichromacy in which the patient does not have any functional L cones, only S and M cones. The patient practiced the Farnsworth D15 test and returned for a follow-up visit in which he performed the test perfectly four times (i.e., twice in the regular order and twice using cap 15 as the pilot cap). In addition, the patient returned a year later and again performed the test perfectly, indicating long-term learning.

All studies to date have shown that patients with dichromacy fail the Farnsworth D15 test. This case report shows that it is indeed possible for highly motivated patients to subvert the test through practice, and knowledge of this possibility is very important, especially in occupational testing.