Female Color Vision Deficiency is Associated with Increased Prevalence of Amblyopia, Strabismus and Ametropia

To examine the association between female color vision deficiency (CVD) and other ophthalmic disorders including amblyopia and strabismus.

A retrospective, cross-sectional analysis of female adolescents undergoing military medical assessments between the years 2000 and 2020 was conducted. The prevalence of ophthalmic conditions, such as amblyopia, strabismus, and ametropia, was examined in both females with CVD and those with normal color vision. Demographic and socioeconomic data were also collected and analyzed.

912 females with CVD (mean age 17.1 ± 0.2 years) were identified within a cohort of 621,471 Israeli army female recruits. Female adolescents with CVD had higher prevalence of amblyopia (4.61% vs 0.66%, p < 0.001), strabismus (2.96% vs 0.81%, p < 0.001), and ametropia (moderate - less than 6.00 diopters, 40.46% vs 37.48%, p < 0.001, and high - higher than 6.00 diopters, 4.50% vs 1.95% p < 0.001) compared to females with normal color vision. Specific refractive data was available for a subgroup of 256 CVD females, demonstrating higher prevalence of both mild to moderate hyperopia (up to +6.00 diopters, 7.36% vs 2.72%, p < 0.001) and high hyperopia (≥ +6.00 diopters, 1.16% vs 0.13%, p < 0.001), but not for myopia or astigmatism.

CVD in young females is strongly associated with strabismus, hyperopia and amblyopia, suggesting that early population screening for CVD at a young age could identify girls at a higher risk for preventable vision loss.