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Colour vision screening in children: an evaluation of three pseudoisochromatic tests
1Department of Optometry and Visual Science, City University, London, UK.
Insights
This study evaluated pseudoisochromatic tests for childhood color vision screening. The Ishihara test for Unlettered Persons
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Color Vision Deficiencies
Background:
- Color vision deficiency (CVD) affects a significant portion of the population.
- Early detection of CVD in children is crucial for educational and developmental reasons.
- Assessing color vision in young children presents unique challenges.
Purpose of the Study:
- To compare the effectiveness of three pseudoisochromatic tests for screening color vision in children aged 3-11 years.
- To identify the most suitable tests and methods for different age groups.
- To determine optimal screening strategies for childhood color vision assessment.
Main Methods:
- Evaluated 513 children (258 boys, 255 girls) aged 3-11 years.
- Utilized three pseudoisochromatic tests: Ishihara (numeral designs), Ishihara for Unlettered Persons (symbol designs), and Velhagen Pfügertrident.
- Assessed test speed, effectiveness, and accuracy based on age and response method (verbal identification, drawing, replica selection).
Main Results:
- Eighteen children (3.5%) were diagnosed with color vision deficiency.
- The Ishihara test for Unlettered Persons (symbol designs) was fastest and most effective for children under 7.
- For children over 7, both the Unlettered Persons symbols and Ishihara numerals were equally effective; verbal identification yielded the most accurate results.
- The Velhagen Pfügertrident test was unreliable for screening.
Conclusions:
- The Ishihara test for Unlettered Persons is recommended for screening younger children (under 7).
- For older children (7+), both Ishihara numeral and Unlettered Persons symbol designs are effective, with verbal identification being optimal.
- The Velhagen Pfügertrident test is not recommended for childhood color vision screening.
Abstract:
We examined 513 children (258 boys and 255 girls), between 3 and 11 years of age, with three pseudoisochromatic tests which involve different visual tasks. These were a selection of numeral designs from the Ishihara test, the Ishihara test for Unlettered Persons and the Velhagen Pfügertrident test. Eighteen children were found to be colour deficient. The symbol designs of the Unlettered Persons test were found to be the quickest and most effective method for examining children under 7 years of age. After 7 years of age the symbol designs of the Unlettered test and the numeral designs of Ishihara test were equally effective. The preferred numeral designs for screening children with the Ishihara plates are listed. Verbal identification always produced the most accurate results. Drawing over the figures or selecting replicas increased the viewing time and assisted children with normal colour vision to see both figures in transformation designs, especially pathway designs. The Velhagen Pfügertrident test was found to be unreliable for colour vision screening and younger children had difficulty performing the figure matching task.