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Color vision screening: a comparison of the AO H-R-R and Farnsworth F-2 tests
Insights
The Farnsworth F-2 test and AO H-R-R plates effectively screen for red-green color vision defects in older children. Both tests showed comparable accuracy in grades 4 through high school, identifying expected deficiency rates.
Area of Science:
- Ophthalmology
- Vision Science
- Pediatric Optometry
Background:
- Effective vision screening requires reliable color vision defect tests.
- Red-green color vision deficiencies are common and impact daily life.
- Existing screening methods need validation for accuracy across age groups.
Purpose of the Study:
- To compare the Farnsworth F-2 test and AO H-R-R pseudoisochromatic plates as primary screening tools for red-green color vision defects.
- To evaluate the performance of these tests in children from kindergarten through high school.
- To determine the reliability and validity of the Farnsworth F-2 test as a single-plate screening option.
Main Methods:
- Administered the Farnsworth F-2 test and AO H-R-R plates to 2827 children (K-12).
- Analyzed failure rates across different grade levels.
- Compared test results against expected prevalence of red-green color vision deficiencies.
Main Results:
- Both tests showed higher failure rates than expected in lower grades (K-3).
- In grades 4-12, failure rates were comparable: 4.16% for F-2 and 4.02% for AO H-R-R, aligning with the predicted 4.2% population incidence.
- Farnsworth F-2 test failure rates for high school boys (7.3%) and girls (0.89%) closely matched expected sex-specific incidences.
Conclusions:
- The Farnsworth F-2 test is a comparable and excellent single-plate screening tool for red-green color vision defects in students from grade 2 upwards.
- While some normal-vision young children may fail the F-2 due to difficulty with the blue square, its overall screening utility is high.
- The AO H-R-R test also demonstrated effectiveness, with minor discrepancies in mild or borderline cases not considered practically significant.
Abstract:
Vision screening tests should include a simple, reliable, and valid test of color vision defects. In this investigation the single plate Farnsworth F-2 test and the AO H-R-R pseudoisochromatic plates were compared as primary screening tests for red-green color defective vision. The tests were administered to 2827 children, kindergarten through high school grades. Both tests failed a higher percentage of children than expected in the lower grades (kindergarten through 3). In grades 4 through high school, however, 4.16% failed the F-2 test and 4.02% failed the AO H-R-R, compared to a predicted 4.2% of the general population with inherited red-green deficiencies. The failure rates of the F-2 test for 1171 high school boys and girls were 7.3 and 0.89%, respectively, very close to the expected incidence of red-green defects in males and females. Although the F-2 test passed a few pupils who failed the AO H-R-R test, their defects were categorized as mild or borderline on the AO H-R-R test and therefore not likely to be of practical significance. Less than 0.5% of the children in grades 4 through high school failed the F-2 test after passing the AO H-R-R. Some children with normal color vision, particularly very young children, may fail the F-2 test because of difficulty picking out the less obvious blue square. Nevertheless, for screening purposes the F-2 test is comparable to the AO H-R-R test and except for kindergarten and grade 1 pupils is an excellent single plate color vision screening test.(ABSTRACT TRUNCATED AT 250 WORDS)