Colour vision deficiency

Color Quest: An interactive tool for exploring color palettes and enhancing accessibility in data visualization

Data visualization plays a vital role in modern scientific communication across diverse domains, shaping the understanding of complex information through color choices. However, the significance of color palette selection goes beyond aesthetics and scientific communication, encompassing accessibility for all, especially individuals with color vision deficiencies. To address this challenge, we introduce "Color Quest," an intuitive Shiny app that empowers users to explore color palettes for data visualization while considering inclusivity. The app allows users to visualize palettes across various types of plots and maps envisioning how they appear to individuals with color blindness. In addition, it enables users to visualize palettes on their own custom-uploaded images. This short communication presents the app's design, interactive interface, and transformative potential in enhancing data visualization practices. Developed using open-source standards, Color Quest aligns with accessibility discussions, offering a practical tool and platform for raising awareness about inclusive design. Its open-source nature fosters transparency, community collaboration, and long-term sustainability. Color Quest's practicality renders it indispensable for scientific domains, simplifying palette selection and promoting accessibility. Its impact extends beyond academia to diverse communication settings, harmonizing information dissemination, aesthetics and accessibility for more impactful scientific communication.

Colour perception develops throughout childhood with increased risk of deficiencies in children born prematurely

AIM

To quantify the impact of prematurity on chromatic discrimination throughout childhood, from 2 to 15 years of age.

METHODS

We recruited two cohorts of children, as part of the TrackAI Project, an international project with seven different study sites: a control group of full-term children with normal visual development and a group of children born prematurely. All children underwent a complete ophthalmological exam and an assessment of colour discrimination along the three colour axes: deutan, protan and trytan using a DIVE device with eye tracking technology.

RESULTS

We enrolled a total of 1872 children (928 females and 944 males) with a mean age of 6.64 years. Out of them, 374 were children born prematurely and 1498 were full-term controls. Using data from all the children born at term, reference normative curves were plotted for colour discrimination in every colour axis. Pre-term children presented worse colour discrimination than full-term in the three colour axes (p < 0.001). Even after removing from the comparison, all pre-term children with any visual disorder colour discrimination outcomes remained significantly worse than those from full-term children.

CONCLUSION

While colour perception develops throughout the first years of life, children born pre-term face an increased risk for colour vision deficiencies.

Dyschromatopsia: a comprehensive analysis of mechanisms and cutting-edge treatments for color vision deficiency

Color blindness is a retinal disease that mainly manifests as a color vision disorder, characterized by achromatopsia, red-green color blindness, and blue-yellow color blindness. With the development of technology and progress in theory, extensive research has been conducted on the genetic basis of color blindness, and various approaches have been explored for its treatment. This article aims to provide a comprehensive review of recent advances in understanding the pathological mechanism, clinical symptoms, and treatment options for color blindness. Additionally, we discuss the various treatment approaches that have been developed to address color blindness, including gene therapy, pharmacological interventions, and visual aids. Furthermore, we highlight the promising results from clinical trials of these treatments, as well as the ongoing challenges that must be addressed to achieve effective and long-lasting therapeutic outcomes. Overall, this review provides valuable insights into the current state of research on color blindness, with the intention of informing further investigation and development of effective treatments for this disease.

Prevalence of Congenital Color Vision Deficiency in Southern Taiwan and Detection of Female Carriers by Visual Pigment Gene Analysis

This study aimed to investigate the prevalence of color vision deficiencies (CVDs) and determine whether carriers could be detected by analyzing the visual pigment genes. Materials and Methods: The data of students who underwent routine CVD screening using the Ishihara color test in Kaohsiung, Southern Taiwan were analyzed. Furthermore, the DNA samples of 80 randomly selected females and four obligate carriers were analyzed. The most upstream genes, downstream genes, and the most downstream genes in the red/green pigment gene arrays were amplified separately using polymerase chain reaction (PCR), and exon 5 of each gene was analyzed. The prevalence of congenital red-green CVD in this study was 3.46% in males and 0.14% in females. The PCR analysis of the first gene, downstream gene, and last gene revealed normal patterns in 73 normal cases. Seven unusual patterns were detected in two proton carriers and five deutan carriers. Among the randomly selected females, 8.8% (7/80) were CVD carriers. The prevalence of CVD among male Taiwanese students in this study was 3.46%. Female carriers of congenital CVD can be identified by molecular analysis of the visual pigment genes. The proportion of CVD carriers among the randomly selected females was 8.8%, which was slightly higher than expected and further studies are warranted.

Influence of colour vision on attention to, and impression of, complex aesthetic images

Humans exhibit colour vision variations due to genetic polymorphisms, with trichromacy being the most common, while some people are classified as dichromats. Whether genetic differences in colour vision affect the way of viewing complex images remains unknown. Here, we investigated how people with different colour vision focused their gaze on aesthetic paintings by eye-tracking while freely viewing digital rendering of paintings and assessed individual impressions through a decomposition analysis of adjective ratings for the images. Gaze-concentrated areas among trichromats were more highly correlated than those among dichromats. However, compared with the brief dichromatic experience with the simulated images, there was little effect of innate colour vision differences on impressions. These results indicate that chromatic information is instructive as a cue for guiding attention, whereas the impression of each person is generated according to their own sensory experience and normalized through one's own colour space.

Impact of color vision deficiency on the quality of life in a sample of Indian population: Application of the CVD-QoL tool

Purpose

To investigate the quality of life (QoL) in a sample of color vision deficit (CVD) patients in India and how color vision deficiency affects them psychologically, economically, and in productivity related to their work and occupation.

Methods

A descriptive and case-control study design using a questionnaire was conducted on N = 120 participants, of whom 60 were patients of CVD (52 male and eight female) who visited two eye facilities in Hyderabad between 2020 and 2021 and 60 were age-matched normal color vision participants who served as controls. We validated English-Telugu adapted version of CVD-QoL, developed by Barry et al. in 2017 (CB-QoL). The CVD-QoL consists of 27 Likert-scale items with factors (lifestyle, emotions, and work). Color vision was assessed using the Ishihara and Cambridge Mollen color vision tests. A six-point Likert scale was used, with lower scores indicating poor QoL (from 1 = severe issue to 6 = no problem).

Results

The CVD-QoL questionnaire's reliability and internal consistency were measured, including Cronbach's α (α =0.70-0.90). There was no significance between the group in age (t = -1.2, P = 0.67) whereas the Ishihara colour vision test, scores showed a significant difference (t = 4.50, P < 0.001). The QoL scores showed a significant difference towards lifestyle, emotions and work (P = 0.001). The CVD group had a poorer QoL score than the normal color vision group odds ratio [OR] =0.31, 95% confidence interval [CI], (P = 0.002, CI = 0.14-0.65, Z = 3.0) . In this analysis, a low CI indicated that the OR was more precise.

Conclusion

Color vision deficiency affects Indians' QoL, according to this study. The mean scores of lifestyle, emotions, and work were lower than the UK sample.Since CVD is underreported and possibly affects developing countries more, advocacy for a new health care plan on CVD is essential. Increasing public understanding and awareness could also help diagnosing the CVD population.

Additive effects of narrowband light and optical defocus on chick eye growth and refraction

BACKGROUND

In the past decade and during the COVID pandemic, the prevalence of myopia has reached epidemic proportions. To address this issue and reduce the prevalence of myopia and its complications, it is necessary to develop more effective interventions for controlling myopia. In this study, we investigated the combined effects of narrowband lights and competing defocus on eye growth and refraction in chicks, an important step in understanding the potential for these interventions to control myopia. This is the first time these effects have been characterized.

METHODS

Three groups of five-day-old chicks (n = 8 per group) were raised in three different lighting conditions: white, red, and blue for 13 days in a 12/12-h light/dark diurnal cycle. One eye was randomly selected for applications of a dual-power optical lens (- 10 D/ + 10 D, 50∶50), while another eye was left untreated as control. Vitreous chamber depth (VCD), axial length (AL), choroidal thickness (CT) and refractive errors were measured at pre-exposure (D0) and following 3 (D3), 7 (D7), 10 (D10), and 13 days (D13) of light exposure.

RESULTS

Under white light, the dual-power lens induced a hyperopic shift [at D13, mean spherical equivalent refraction (SER), treated vs. control: 4.81 ± 0.43 D vs. 1.77 ± 0.21 D, P < 0.001] and significantly reduced the progression of axial elongation (at D13, change in AL, treated vs. control: 1.25 ± 0.04 mm vs. 1.45 ± 0.05 mm, P < 0.01). Compared to white light alone, blue light alone induced a hyperopic shift (at D13, mean SER, blue vs. white: 2.75 ± 0.21 D vs. 1.77 ± 0.21 D, P < 0.01) and significantly reduced axial elongation (at D13, change in AL, blue vs. white: 1.17 ± 0.06 mm vs. 1.45 ± 0.05 mm, P < 0.01) in control eyes. When comparing all conditions, eyes exposed to blue light plus dual-power lens had the least axial elongation (at D13, change in AL, 0.99 ± 0.05 mm) and were the most hyperopic (at D13, mean SER, 6.36 ± 0.39 D).

CONCLUSIONS

Both narrowband blue light and dual-power lens interventions were effective in inducing a hyperopic shift in chicks, and provided protection against myopia development. The combination of these interventions had additive effects, making them potentially even more effective. These findings support the use of optical defocus interventions in combination with wavelength filters in clinical studies testing their effectiveness in treating myopia in children.

Masking Colour Blindness: A Case Report

Colour vision is an important aspect of visual function that might help individuals in doing daily activities. Some occupations require and test for good colour discrimination. We describe a case of a 20-year-old man who was referred to our centre to establish if he had colour vision deficiency (CVD). He had been tested for this twice as part of his assessment to enter the police force. At the first examination, he had normal colour vision, while the second examination revealed CVD, thus the patient was referred for confirmation. Colour vision tests using the Ishihara plates showed normal results with each eye, while a Roth test revealed an unspecified CVD in the right eye and deuteranopia in the left eye. During the evaluation, we noticed he was using a red-tinted contact lens in the right eye, and was wearing a red mask with transparent red plastic in the upper part. After removal of the contact lens and mask, he was asked to repeat the examinations and it revealed deuteranopia in both eyes. A tinted contact lens is a corrective device that can help to enhance colour discrimination in CVD subjects. However, in this case the tinted contact lens was used inappropriately to manipulate the colour vision examination. We highlight the case to raise awareness that the use of red contact lenses and red filters can mask CVD.

Lanthony D15 for Occupational Testing: Short-term Repeatability

SIGNIFICANCE

The Lanthony D15 has been reported to have poorer repeatability than the Farnsworth D15. This study found that two trials of the test provide high short-term repeatability and can be administered this way for occupational testing.

PURPOSE

This study aimed to determine the short-term repeatability of the Lanthony D15 in patients with color vision deficiency. Repeated trials were used to examine if learning effects occur and to determine how many trials would be necessary to ensure the highest short-term repeatability for occupational testing.

METHODS

Twenty male subjects (mean [standard deviation] age, 27.2 [4.3] years) with congenital color vision deficiency, ranging from mild to severe, participated in this single-visit study. Visual acuity, color vision book screening, Farnsworth D15, and anomaloscope testing were performed for classification purposes. Ten trials of the Lanthony D15 were performed. Color confusion index scores from each trial were determined, and a repeated-measures analysis of variance was used to compare the scores across trials. Orthogonal polynomial analysis was performed to detect any trends across trials through the third order. The intraclass correlation coefficient was calculated.

RESULTS

No differences in color confusion index (mean [standard error of the mean], 3.57 [0.04]) were found across the 10 trials ( P = .18). Legendre polynomials showed no statistical significance (all P > .39). The intraclass correlation coefficient was 0.81 (95% confidence interval, 0.70 to 0.90). Based on the method of Shrout and Fleiss, intraclass correlation coefficients of 0.7, 0.8, and 0.9 could be achieved with an average of one, two, and four trials of the test, respectively. However, empirically, 0.9 was not achievable.

CONCLUSIONS

The Lanthony D15 test has fairly high short-term repeatability. Thus, although more trials would likely improve clinical certainty, the mean result of two trials appears sufficient for occupational testing.

On the importance of color in mass spectrometry imaging

Mass spectrometry imaging (MSI) data visualization relies on heatmaps to show the spatial distribution and measured abundances of molecules within a sample. Nonuniform color gradients such as jet are still commonly used to visualize MSI data, increasing the probability of data misinterpretation and false conclusions. Also, the use of nonuniform color gradients and the combination of hues used in common colormaps make it challenging for people with color vision deficiencies (CVDs) to visualize and accurately interpret data. Here we present best practices for choosing a colormap to accurately display MSI data, improve readability, and accommodate all CVDs. We also provide other resources on the misuse of color in the scientific field and resources on scientifically derived colormaps presented herein.

microshades: An R Package for Improving Color Accessibility and Organization of Microbiome Data

When creating figures, it is important to consider that individuals with color vision deficiency (CVD) may not perceive all colors. While there are several CVD-friendly color palettes, they are often insufficient for working with microbiome data. Here, we introduce microshades, an R package for creating CVD-accessible microbiome figures.

High visibility colored fabrics for normal trichromats and individuals with color vision defects in a sunset-simulated environment

This study aimed to investigate the visibility of colors in congenitally color vision defect people using general and fluorescent colors in an environment simulating sunset to examine the standards for high-visibility safety clothing for general users. Twenty participants with normal trichromats, seven protanopes, and five deuteranopes were included, with mean ages (± standard deviation) of 21.0±1.0, 46,7±16.1, and 56.6±6.9 years, respectively. Dyed fabrics were used to evaluate visibility. We evaluated brightness and conspicuousness sensitivity by combining red, yellow-red, yellow, green, red-purple, blue, white, black, fluorescent yellow, and fluorescent orange. For brightness sensitivity, the combination of fluorescent yellow and white/yellow stripes was highly visible and significantly different from all other samples (p < 0.05). For conspicuousness sensitivity, the combinations of black/fluorescent yellow, black/yellow, black/white, black/yellow-red, and white/red-purple stripes were highly visible and significantly different from all the other samples (p < 0.05). Yellow light is most visible and even better when fluorescent. They are based on specific spectral sensitivity, and yellow is the most visible, even for congenitally colorblind individuals. Furthermore, with regard to color combinations, it was found that the contrast between two distinct light or dark colors, such as black, yellow, black, and white, is perceived to be equally noticeable by congenital color vision defect individuals. This suggests the possible further applications of safety clothing.

CVD-MET: an image difference metric designed for analysis of color vision deficiency aids

Color vision deficiency (CVD) has gained in relevance in the last decade, with a surge of proposals for aid systems that aim to improve the color discrimination capabilities of CVD subjects. This paper focuses on the proposal of a new metric called CVD-MET, that can evaluate the efficiency and naturalness of these systems through a set of images using a simulation of the subject's vision. In the simulation, the effect of chromatic adaptation is introduced via CIECAM02, which is relevant for the evaluation of passive aids (color filters). To demonstrate the potential of the CVD-MET, an evaluation of a representative set of passive and active aids is carried out both with conventional image quality metrics and with CVD-MET. The results suggest that the active aids (recoloration algorithms) are in general more efficient and produce more natural images, although the changes that are introduced do not shift the CVD's perception of the scene towards the normal observer's perception.

A case of schizophrenia with congenital color vision deficiency: From the perspective of color universal design to promote medication adherence

Color‐blindness, or more accurately, color vision deficiency (CVD), which is the inability or decreased ability to distinguish different colors, is one of the commonest visual disorders. Patients with schizophrenia usually have multiple types of visual processing impairments, including color vision impairments. Here, we present a case of schizophrenia with congenital CVD. The patient was aware of his color deficiency since elementary school. We assessed his ability to distinguish medicines based on their color, including those that he had been previously prescribed. Although he could distinguish all of the tablets, he could not distinguish the color of the blister packs, specifically that of the bromazepam 2 mg pack (green) from the 1 mg pack (red). This case suggests that CVD patients might misunderstand the color of medications, which might lead to medication errors, or poor drug adherence. The color universal design principle should be considered when designing tablets and their blister packs, in order to improve medication adherence.

Color vision devices for color vision deficiency patients: A systematic review and meta‐analysis

Background and Aims

There is insufficient evidence to support that using electronic or optical color vision devices improve color perception with current advanced technology. The purpose of this study is to compare and analyze the different color vision devices available for patients with color vision deficiency (CVD) and evaluate whether these devices improved their color perception.

Methods

This review included randomized, experimental, comparative studies, as well as narrative reviews, prototype and innovation studies, and translational studies, followed by case‐control and clinical trials with nonsurgical interventions studies, that is, electronic color vision devices, optical devices, and contact lens‐based studies, with standardized inclusion and exclusion criteria.

Results

The primary outcome studied was the performance of color vision devices, both objective and subjective. Secondary outcomes included the ease of use and accessibility of color vision devices and technology. The grading of recommendation, assessment, development, and evaluation framework was used to develop a systematic approach for consideration and clinical practice recommendation for CVD devices for color‐deficient populations. We incorporated meta‐analysis reports from a total of n = 16 studies that met the criteria which consisted of case‐control studies, prototype and innovation studies, comparative studies, pre‐ and post‐clinical trial studies, case studies, and narrative reviews. Proportion and standard errors, as well as correlations, were calculated from the meta‐analysis for various available color vision devices.

Conclusion

This review concludes that commercially available color vision devices, such as EnChroma Glasses, Chromagen filters, and EnChroma Cx‐14 do not provide clinically significant evidence that subjective color perception has improved. As a result, recommending these color vision devices to the CVD population may not prove high beneficial/be counterproductive. However, only a few color shades can be perceived differently. This systematic review and analysis will aid future research and development in color vision devices.

Color Vision Deficiency Survey in Anatomic Pathology

OBJECTIVES

To learn what color vision-deficient pathologists and cytotechnologists consider their most significant problems and advantages as well as any accommodations.

METHODS

An anonymous online survey developed for practicing pathologists and cytotechnologists regarding their experiences with stains was sent to the members of 4 national societies.

RESULTS

We received 377 responses. Twenty-three people, all men, identified themselves as color vision deficient, with 22 reporting red-green color vision deficiency and 1 reporting uncertain type. Eight pathologists and cytotechnologists indicated that they thought that their color vision deficiency conferred advantages to them, including a greater appreciation of morphology, with less confusion resulting from variations in stain quality or intensity. Nineteen pathologists and cytotechnologists thought that their color vision deficiency conferred disadvantages; the most common disadvantages stated were the identification of eosinophils and acid-fast bacilli. Other difficulties included interpretation of RBCs and nucleoli and sometimes Alcian blue, Brown and Brenn, Congo red, crystal violet, Fite, Giemsa, mucicarmine, periodic acid-Schiff, and fluorescence in situ hybridization stains. Only 2 of the color vision-deficient pathologists and cytotechnologists found digital slides more difficult than glass slides.

CONCLUSIONS

Color vision-deficient pathologists and cytotechnologists report that they have developed approaches to viewing slides that do not compromise their interpretations. Digital pathology may provide several approaches for aiding color vision-deficient pathologists with the interpretation of certain stains.

Variation and heritability of retinal cone ratios in a free-ranging population of rhesus macaques

A defining feature of catarrhine primates is uniform trichromacy-the ability to distinguish red (long; L), green (medium; M), and blue (short; S) wavelengths of light. Although the tuning of photoreceptors is conserved, the ratio of L:M cones in the retina is variable within and between species, with human cone ratios differing from other catarrhines. Yet, the sources and structure of variation in cone ratios are poorly understood, precluding a broader understanding of color vision variability. Here, we report a large-scale study of a pedigreed population of rhesus macaques (Macaca mulatta). We collected foveal RNA and analyzed opsin gene expression using cDNA and estimated additive genetic variance of cone ratios. The average L:M ratio and standard error was 1.03:1 ± 0.02. There was no age effect, and genetic contribution to variation was negligible. We found marginal sex effects with females having larger ratios than males. S cone ratios (0.143:1 ± 0.002) had significant genetic variance with a heritability estimate of 43% but did not differ between sexes or age groups. Our results contextualize the derived human condition of L-cone dominance and provide new information about the heritability of cone ratios and variation in primate color vision.

Diagnosis of colour vision deficits using eye movements

We set out to develop a simple objective test of functional colour vision based on eye movements made in response to moving patterns. We exploit the finding that while the motion of a colour-defined stimulus can be cancelled by adding a low-contrast luminance-defined stimulus moving in the opposite direction, the "equivalent luminance contrast" required for such cancellation is reduced when colour vision is abnormal. We used a consumer-grade infrared eye-tracker to measure eye movements made in response to coloured patterns drifting at different speeds. An automated analysis of these movements estimated individuals' red-green equiluminant point and their equivalent luminance contrast. We tested 34 participants: 23 colour vision normal controls, 9 deuteranomalous and 2 protanomalous individuals. We obtained reliable estimates of strength of directed eye movements (i.e. combined optokinetic and voluntary tracking) for stimuli moving at 16 deg/s and could use these data to classify participants' colour vision status with a sensitivity rate of 90.9% and a specificity rate of 91.3%. We conclude that an objective test of functional colour vision combining a motion-nulling technique with an automated analysis of eye movements can diagnose and assess the severity of protanopia and deuteranopia. The test places minimal demands on patients (who simply view a series of moving patterns for less than 90 s), requires modest operator expertise, and can be run on affordable hardware.

Color vision deficiencies and camouflage: a comparative study between normal and CVD observers

There is a belief that observers with color vision deficiencies (CVD) perform better in detecting camouflaged objects than normal observers. Some studies have concluded contradictory findings when studying the performance of normal and CVD observers in the camouflage detection tasks in different conditions. This work presents a literature review on this topic, dividing it into three different and contradictory types of results: better performance for CVD, for normal observers, or same performance. Besides, two psychophysical experiments have been designed and carried out in a calibrated computer monitor on both normal and CVD human observers to measure the searching times of the different types of observers needed to find camouflaged stimuli in two different types of stimuli. Results show the trend that, in our experimental conditions, normal observers need shorter searching times than CVD observers in finding camouflaged stimuli both in images of natural scenes and in images with synthetic stimuli.

Prevalence and population genetic data of colour vision deficiency among students from selected tertiary institutions in Lagos State, Nigeria

Background

Colour vision deficiency (CVD), also referred to as colour blindness, is the failure or decreased ability to distinguish between certain colours under normal lighting conditions. It is an X-linked genetic disorder with varying degrees of prevalence in different populations. There is presently no report on the prevalence of CVD among students of the selected tertiary institution. Hence, the present study was aimed at determining the occurrence and genetics of CVD among students from designated tertiary institutions in Lagos state. A cross-sectional survey was employed in recruiting 1191 study subjects from three tertiary institutions in Lagos, Nigeria.

Results

The overall occurrence of CVD among the study participants was 2.85%. There were 24 (4.29%) males and 10 (1.58%) females affected. Among the colour vision deficient individuals, 18 (1.51%) and 16 (1.34%) were deuteranomalous and protanomalous, respectively. Also, the prevalence of CVD varies across ethnic groups of the studied subjects with the highest occurrences (3.57%) observed in the Yoruba ethnic subpopulation and the least (1.45%) among the Hausas.

Conclusions

More males than females were found to be colour vision deficient, and there were more deutans than protans. Early screening for CVD should be encouraged among school children to guide the choice of future profession and help mitigate work hazards resulting from being colour deficient.

Inverse-Designed Aid Lenses for Precise Correction of Color Vision Deficiency

Color vision deficiency (CVD) is a common ocular disorder affecting more than 300 million people on the earth. Although no clinical cure for the disorder currently exists, some specialized color filtering glasses/lenses based on dyes, metasurfaces, or nanocomposites have been employed for CVD management. However, as CVD patients usually diversify in their classification and severity, none of the current lenses provides a customized correction for various CVD patients, resulting in undesirable correction effects. Here, we present an inverse-designed approach for the precise correction of CVD. The wavelength shift of a patient's abnormal cone photoreceptors was measured to inversely design the best blocking wavelength and blocking rate of the lens. Then the customized aid lenses were fabricated using silica-coated gold nanoparticles with appropriate sizes and concentrations, verified by the simulated color vision and human tests. This study demonstrates the potential of the inverse-designed aid lenses in precise color filtering and customized CVD management.

Two-dimensional biocompatible plasmonic contact lenses for color blindness correction

Color blindness, or color vision deficiency (CVD), is an ocular disease that suppresses the recognition of different colors. Recently, tinted glasses and lenses have been studied as hopeful devices for color blindness correction. In this study, 2D biocompatible and flexible plasmonic contact lenses were fabricated using polydimethylsiloxane (PDMS) and a low-cost, and simple design based on the soft nano-lithography method and investigated for correction of red-green (deuteranomaly) color blindness. In addition, the stability test of the fabricated plasmonic contact lenses was investigated into the phosphate buffered saline (PBS) solution and the proposed lens offers an excellent stability into the PBS solution. The plasmonic contact lens proposed herein is based on the plasmonic surface lattice resonance (SLR) phenomenon and offers a good color filter for color blindness correction. The biocompatibility, low cost, stability, and simple fabrication of these contact lenses can offer new insights for applications of color blindness correction.

A Meta-Analysis of Wearable Contact Lenses for Medical Applications: Role of Electrospun Fiber for Drug Delivery

In recent years, wearable contact lenses for medical applications have attracted significant attention, as they enable continuous real-time recording of physiological information via active and noninvasive measurements. These devices play a vital role in continuous monitoring of intraocular pressure (IOP), noninvasive glucose monitoring in diabetes patients, drug delivery for the treatment of ocular illnesses, and colorblindness treatment. In specific, this class of medical devices is rapidly advancing in the area of drug loading and ocular drug release through incorporation of electrospun fibers. The electrospun fiber matrices offer a high surface area, controlled morphology, wettability, biocompatibility, and tunable porosity, which are highly desirable for controlled drug release. This article provides an overview of the advances of contact lens devices in medical applications with a focus on four main applications of these soft wearable devices: (i) IOP measurement and monitoring, (ii) glucose detection, (iii) ocular drug delivery, and (iv) colorblindness treatment. For each category and application, significant challenges and shortcomings of the current devices are thoroughly discussed, and new areas of opportunity are suggested. We also emphasize the role of electrospun fibers, their fabrication methods along with their characteristics, and the integration of diverse fiber types within the structure of the wearable contact lenses for efficient drug loading, in addition to controlled and sustained drug release. This review article also presents relevant statistics on the evolution of medical contact lenses over the last two decades, their strengths, and the future avenues for making the essential transition from clinical trials to real-world applications.

Clinically relevant colour album test for the colour defective medical student

Purpose:

Methods:

Results:

Conclusion:

Oscillatory Potentials in Achromatopsia as a Tool for Understanding Cone Retinal Functions

Achromatopsia (ACHM) is an inherited autosomal recessive disease lacking cone photoreceptors functions. In this study, we characterize the time-frequency representation of the full-field electroretinogram (ffERG) component oscillatory potentials (OPs), to investigate the connections between photoreceptors and the inner retinal network using ACHM as a model. Time-frequency characterization of OPs was extracted from 52 controls and 41 achromat individuals. The stimulation via ffERG was delivered under dark-adaptation (DA, 3.0 and 10.0 cd·s·m-2) to assess mixed rod-cone responses. The ffERG signal was subsequently analyzed using a continuous complex Morlet transform. Time-frequency maps of both DA conditions show the characterization of OPs, disclosing in both groups two distinct time-frequency windows (~70-100 Hz and >100 Hz) within 50 ms. Our main result indicates a significant cluster (p < 0.05) in both conditions of reduced relative power (dB) in ACHM people compared to controls, mainly at the time-frequency window >100 Hz. These results suggest that the strongly reduced but not absent activity of OPs above 100 Hz is mostly driven by cones and only in small part by rods. Thus, the lack of cone modulation of OPs gives important insights into interactions between photoreceptors and the inner retinal network and can be used as a biomarker for monitoring cone connection to the inner retina.

True colours or red herrings?: colour maps for finite-element analysis in palaeontological studies to enhance interpretation and accessibility

Accessibility is a key aspect for the presentation of research data. In palaeontology, new data is routinely obtained with computational techniques, such as finite-element analysis (FEA). FEA is used to calculate stress and deformation in objects when subjected to external forces. Results are displayed using contour plots in which colour information is used to convey the underlying biomechanical data. The Rainbow colour map is nearly exclusively used for these contour plots in palaeontological studies. However, numerous studies in other disciplines have shown the Rainbow map to be problematic due to uneven colour representation and its inaccessibility for those with colour vision deficiencies. Here, different colour maps were tested for their accuracy in representing values of FEA models. Differences in stress magnitudes (ΔS) and colour values (ΔE) of subsequent points from the FEA models were compared and their correlation was used as a measure of accuracy. The results confirm that the Rainbow colour map is not well suited to represent the underlying stress distribution of FEA models with other colour maps showing a higher discriminative power. As the performance of the colour maps varied with tested scenarios/stress types, it is recommended to use different colour maps for specific purposes.

A large population study reveals a novel association between congenital color vision deficiency and environmental factors

PURPOSE

To assess the associations between the prevalence of congenital color vision deficiency (CVD) and genetics and environment, represented by place of origin (ethnic background) and place of birth, respectively.

METHODS

This is a retrospective study of the computerized database of the northern recruitment center of Israel of 53,895 consecutive male Jewish conscripts 16-19 years old, who completed the medical profiling process between 1988 and 2011. CVD was diagnosed using the 24-pseudo-isochromatic plate Ishihara test. Associations of CVD prevalence with sociodemographic variables, anthropometric indices, refractive errors, and mainly place of origin and place of birth were tested by both univariate analysis and multivariate regression models.

RESULTS

Elevated BMI (obesity) and blood pressure (hypertension), as well as myopia, were all positively associated with congenital CVD. The composition of the study population provides a unique opportunity to investigate the relationship between ethnicity and environment. The prevalence of CVD significantly differs among subpopulations of different ethnic background as well as among those who were born in different geographical locations. Additionally, differences in the prevalence of CVD (1.2-1.6%) were observed among conscripts from the same origin, who were born in Israel, compared to those who were born elsewhere. Both place of origin (p < 0.01) and place of birth (p < 0.05) were associated with the prevalence of CVD in a multivariable regression model.

CONCLUSION

This study affirms previously established associations of CVD with certain variables and reveals a possible novel association of CVD with environmental factors.

A mathematical approach to assess the ability of light filters to improve color discriminability of color vision deficient persons

Color vision deficiency (CVD) is a frequent condition that alters color perception to such an extent that many people encounter serious difficulties on their everyday lives. In this work, we present a strategy to analyze the effectiveness of light filters aimed to improve color discriminability of persons with CVD. The calculations are based on a simple model of color discrimination which has been successfully applied to several animal species. We first tested the calculations on three well-known commercial lenses designed for persons with CVD. In agreement with results of clinical studies, the calculations show that the highly colored lenses (VINO® and X-Chrom®) enhance chromaticity contrasts between problematic colors, whereas the more neutral Enchroma® do not provide any benefit. Also, we predict that two light filters proposed in recent works for novel lenses would not improve the performance of the commercial ones. Since the mathematical approach presented in this work enables predictive filter assessment, it opens the door to future research on the design of more effective lenses to improve color discriminability of persons with CVD. The calculations allow for large-scale screening of numerous light filters and different colored stimuli, CVD conditions, light sources, etc.

Recognizing differentiating clinical signs of CLN3 disease (Batten disease) at presentation

Purpose

To help differentiate CLN3 (Batten) disease, a devastating childhood metabolic disorder, from the similarly presenting early‐onset Stargardt disease (STGD1). Early clinical identification of children with CLN3 disease is essential for adequate referral, counselling and rehabilitation.

Methods

Medical chart review of 38 children who were referred to a specialized ophthalmological centre because of rapid vision loss. The patients were subsequently diagnosed with either CLN3 disease (18 patients) or early‐onset STGD1 (20 patients).

Results

Both children who were later diagnosed with CLN3 disease, as children who were later diagnosed with early‐onset STGD1, initially presented with visual acuity (VA) loss due to macular dystrophy at 5–10 years of age. VA in CLN3 disease decreased significantly faster than in STGD1 (p = 0.01). Colour vision was often already severely affected in CLN3 disease while unaffected or only mildly affected in STGD1. Optic disc pallor on fundoscopy and an abnormal nerve fibre layer on optical coherence tomography were common in CLN3 disease compared to generally unaffected in STGD1. In CLN3 disease, dark‐adapted (DA) full‐field electroretinogram (ERG) responses were either absent or electronegative. In early‐onset STGD1, DA ERG responses were generally unaffected. None of the STGD1 patients had an electronegative ERG.

Conclusion

Already upon presentation at the ophthalmologist, the retina in CLN3 disease is more extensively and more severely affected compared to the retina in early‐onset STGD1. This results in more rapid VA loss, severe colour vision abnormalities and abnormal DA ERG responses as the main differentiating early clinical features of CLN3 disease.

Erythropsia and Chromatopsia: Case Study and Brief Review

A 65-year-old woman presented with erythropsia (red-tinged vision) in the right eye from a subfoveal macula dehaemoglobinised intraretinal haemorrhage. Erythropsia is a type of chromatopsia, a condition in which objects appear to be abnormally coloured or tinged with colour. This manuscript provides a brief review of colour vision abnormalities including chromatopsia, and additionally we discuss dyschromatopsia and achromatopsia defined as deficiency and absence of colour vision respectively, both of which may be congenital or acquired. We theorise that the mechanism of the chromatopsia may be selective damage of ganglion cells involved in colour opponency.

Gold Nanocomposite Contact Lenses for Color Blindness Management

Color vision deficiency (CVD) is an ocular congenital disorder that affects 8% of males and 0.5% of females. The most prevalent form of color vision deficiency (color blindness) affects protans and deutans and is more commonly known as "red-green color blindness". Since there is no cure for this disorder, CVD patients opt for wearables that aid in enhancing their color perception. The most common wearable used by CVD patients is a form of tinted glass/lens. Those glasses filter out the problematic wavelengths (540-580 nm) for the red-green CVD patients using organic dyes. However, few studies have addressed the fabrication of contact lenses for color vision deficiency, and several problems related to their effectiveness and toxicity were reported. In this study, gold nanoparticles are integrated into contact lens material, thus forming nanocomposite contact lenses targeted for red-green CVD application. Three distinct sets of nanoparticles were characterized and incorporated with the hydrogel material of the lenses (pHEMA), and their resulting optical and material properties were assessed. The transmission spectra of the developed nanocomposite lenses were analogous to those of the commercial CVD wearables, and their water retention and wettability capabilities were superior to those in some of the commercially available contact lenses used for cosmetic/vision correction purposes. Hence, this work demonstrates the potential of gold nanocomposite lenses in CVD management and, more generally, color filtering applications.

EEG signal analysis during Ishihara's test in subjects with normal vision and color vision deficiency

Color Vision Deficiency (CVD) is one of the most common types of vision deficiency. People with CVD have difficulty seeing color spectra depending on what types of retina photoreceptors are impaired. In this paper, the Ishihara test with 38 plates was used to examine the Electroencephalogram (EEG) of ten subjects with CVD plus ten healthy individuals. The recording was performed according to the 10-20 international system. The C-based software was programmed so that subjects could select the number or path in each test plate in the software options while recording EEG. Frequency features in different frequency bands were extracted from the EEG signals of the two groups during the Ishihara test. Statistically significant differences (P < 0.05) between features were assessed by independent samples t-test with False Discovery Rate (FDR) correction. Also, the K-nearest neighbor classifier (KNN) was used to classify the two groups. The results revealed that the most significant difference between the two groups in the Ishihara test images occurred for the electrodes located in the right temporoparietal areas (P4 and T6) of the brain in the Delta, Theta, Beta1, and Beta2 frequency bands. The KNN classifier, using the signals that reported the greatest statistical difference between the two groups, showed that the two groups were distinguishable with 85.2% accuracy. In this way, images from the Ishihara test that would provide the most accurate classification were identified. In conclusion, this research provided new insights into EEG signals of subjects with CVD and healthy subjects based on the Ishihara color vision test.

Case Report: Effect of Haploscopic Filter on Contrast Sensitivity Function and Color Vision Tests

SIGNIFICANCE

The options that can help patients with congenital color vision defect, to a better professional and leisure adaptation, are very limited. Different haploscopic lenses can be considered, and their effects need to be investigated in patients with different defects.

PURPOSE

The purpose of this study was to present and discuss the effect of a pair of asymmetric long-pass filters fitted for deuteranopia, with the result of a 60% improvement in distinguishing red-green plates when compared with baseline.

CASE REPORT

We report the case of a 51-year-old man with congenital deuteranopia fitted with haploscopic ChromaGen filters. During the 2-month follow-up, we observed a decrease in left-eye logMAR visual acuity and contrast sensitivity with an increased ability to discriminate the plates of different color vision tests (Ishihara, Farnsworth, and Hardy-Rand-Rittler). The visual outcomes are discussed considering the spectral sensitivity curves of each filter, measured with a spectrophotometric device.

CONCLUSIONS

This report describes an improvement in the ability to resolve color vision plates after using asymmetric haploscopic filters showing a left-eye decrease in logMAR visual acuity and contrast sensitivity function. Subjects with a history of color vision deficiency might benefit from using haploscopic filters that selectively minimize the transmittance within a specific bandwidth to improve the color discrimination in deutan color vision deficiency. The simultaneous analysis of the color vision outcomes and transmittance spectrum of the haploscopic filters might contribute to a better understanding of the mechanisms behind the claimed efficacy of these devices.

The Effect of Blue-blocking Lenses on Photostress Recovery Times

SIGNIFICANCE

The selective reduction in visible wavelengths transmitted through commercially available blue-blocking lenses (BBLs) is known to influence the appearance and contrast detection of objects, particularly at low light levels. This influence may impair the human retinal receptor response time to dynamic light changes during photostress events.

PURPOSE

This study aimed to assess whether BBLs selectively affect photostress recovery times (PSRTs) for chromatic and achromatic stimuli of different Weber contrasts that were viewed on a dark black background.

METHODS

Photostress recovery times were measured in 12 younger participants (18 to 39 years old) with no history of ocular disease or abnormal vision. Photostress recovery times were evaluated for four brands of BBLs, which were compared with a control lens. In these experiments, after exposure to an intense light source for 5 seconds, the time taken to recover vision and correctly identify a computer-generated letter stimulus viewed under low and high luminance levels was determined, which means perception is likely to be governed by mesopic and photopic conditions. Across conditions, the letter stimulus was achromatic and chromatic and could differ in luminance contrast.

RESULTS

Under photopic stimulus conditions, although reducing luminance contrast increased PSRTs, BBLs had no significant effect on PSRTs relative to control lens. However, under mesopic stimulus conditions, BBLs significantly affect PSRTs for both achromatic (F2.006,8.02 = 61.95, P < .0001) and chromatic stimuli (F3,16 =139.01, P < .0001), particularly for blue targets, which had considerably longer PSRTs (38.40 seconds). The brand of BBL was also shown to selectively affect PSRTs, with those with transmittance profiles that block the most blue light having longer PSRTs.

CONCLUSIONS

The present study suggests that, although the color and contrast of the target stimuli affected recovery times, the difference in recovery times between different types of BBLs was noticed only under low-light-level stimulus conditions.

Quantitative and objective diagnosis of color vision deficiencies based on steady-state visual evoked potentials

PURPOSE

Traditional color vision tests depend on subjective judgments and are not suitable for infant children and subjects with cognitive dysfunction. We aimed to explore an objective and quantitative color vision testing method based on sweep steady-state visual evoked potentials (sweep SSVEPs) and compare the results with subjective Farnsworth-Munsell (FM) 100-hue test results.

METHODS

A red-green SSVEP pattern reversal checkboard paradigm at different luminance ratios was used to induce visual evoked potentials (VEPs) from 15 color vision deficiencies (CVDs) and 11 normal color vision subjects. After electroencephalography signals were processed by canonical correlation analysis, an equiluminance turning curve corresponding to the activation of the L-cones and M-cones at different levels of color vision was established. Then, we obtained different equiluminance T and proposed the SSVEP color vision severity index (I_CVD) to quantify color vision function and the severity of CVDs. In addition, the FM 100-hue test was used to obtain subjective data for the diagnosis of color vision.

RESULTS

The value of I_CVD can be an indicator of the level of color vision. Both the total error scores (TES) and confusion index (C-index) of the FM 100-hue test were significantly correlated with I_CVD values (P < 0.001, respectively). I_CVD also had a good classification effect in detecting normals, anomalous trichromats and dichromats. Moreover, equiluminance T had a good effect on classifying protans and deutans in subjects with CVDs.

CONCLUSION

Color vision evaluation with sweep SSVEPs showed a good correlation with subjective psychophysical methods. SSVEPs can be an objective and quantitative method to test color vision and diagnose CVDs.

On Random and Systematic Variation in the Prevalence of Defective Color Vision

Defective color vision comes in various forms and its frequency varies from population to population. This article is concerned with only the sex-linked form of essential hereditary color blindness. A model of a 'small' population is constructed to explore the dynamics of occurrence of color blindness. Different mutation rates are introduced for eggs and sperm. Birth and death rates of affected individuals are assumed to be the same as those in the unaffected. Simulation demonstrates that large changes in frequency occur randomly from the combined effects of mutation, transmission of genes from generation to generation and births and deaths. A reference is made to the hypothesis that observed differences in rates are due to selection in the transition from hunter-gatherer to farmer.

Prevalence of colour vision deficiency in the Republic of Ireland schoolchildren and associated socio-demographic factors

CLINICAL RELEVANCE

Early screening is essential to counsel schoolchildren with congenital colour vision deficiency (CVD) in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties.

BACKGROUND

Congenital CVD is an X-linked genetic abnormality relatively commonplace in humans. This study aimed to determine the prevalence of congenital CVD in the Republic of Ireland schoolchildren and associated socio-demographic factors.

METHODS

A total of 1,626 schoolchildren (882 boys and 744 girls), in two age groups (728 aged 6-7-years and 898 aged 12-13-years) were examined from randomly selected schools. Colour vision testing was carried out using the Richmond Hardy-Rand-Rittler pseudoisochromatic test for colour vision (fourth edition); diagnostic plates were used to determine CVD type and extent if participants failed to identify symbols on the screening plates.

RESULTS

CVD was detected in 73 boys (8.3 per cent, 95% confidence interval (CI) 6.6-10.3) and in 13 girls (1.8 per cent, 95% CI 1.0-3.1, p < 0.001). As expected, deutan (boys 4.8 per cent, girls 0.8 per cent) was the most common type of CVD, followed by protan (boys 1.7 per cent, girls 0.1 per cent), unclassified red/green CVD (boys 1.2 per cent, girls 0.8 per cent) and then tritan (boys 0.5 per cent). One case of achromatopsia was detected based on failure on all diagnostic plates. Traveller participants (boys 21.0 per cent, girls 8.6 per cent) had a higher CVD prevalence than their White non-Traveller (boys 7.2 per cent, girls 1.0 per cent) and non-White (boys 5.4 per cent, girls 1.1 per cent) counterparts (odds ratio 3.00, 95% CI 1.1-8.1, p = 0.006). In boys, CVD was also associated with twin birth (odds ratio 2.7, 95% CI 1.1-6.7, p = 0.03) and low birthweight (p = 0.04).

CONCLUSION

This investigation of CVD in the Republic of Ireland schoolchildren should alert clinicians to the association between CVD and Traveller ethnicity, twin birth and lower birthweight. The prevalence of CVD found was similar to previous studies involving predominantly White populations and higher among Traveller participants; hence, counselling regarding inherited anomalies in the Traveller community is recommended. Early screening is essential to counsel schoolchildren with CVD in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties.

Spectral Filter Selection for Increasing Chromatic Diversity in CVD Subjects

This paper analyzes, through computational simulations, which spectral filters increase the number of discernible colors (NODC) of subjects with normal color vision, as well as red-green anomalous trichromats and dichromats. The filters are selected from a set of filters in which we have modeled spectral transmittances. With the selected filters we have carried out simulations performed using the spectral reflectances captured either by a hyperspectral camera or by a spectrometer. We have also studied the effects of these filters on color coordinates. Finally, we have simulated the results of two widely used color blindness tests: Ishihara and Farnsworth-Munsell 100 Hue (FM100). In these analyses the selected filters are compared with the commercial filters from EnChroma and VINO companies. The results show that the increase in NODC with the selected filters is not relevant. The simulation results show that none of these chosen filters help color vision deficiency (CVD) subjects to pass the set of color blindness tests studied. These results obtained using standard colorimetry support the hypothesis that the use of color filters does not cause CVDs to have a perception similar to that of a normal observer.

Prevalence of Color Blindness among Students of Secondary Schools in Shahrekord

Background and aims: Color blindness is a disease that remains undiagnosed in some cases. The diagnosis of the disease during schooling is necessary to take the required measures for the future life of adolescents. Therefore, the aim of this study was to determine the prevalence of color blindness among the students of secondary schools in Shahrekord. Methods: In this descriptive study, 4074 students of secondary schools across Shahrekord were included by the cluster sampling method. Ishihara color blindness test plate was used to diagnose color blindness. Data were analyzed using descriptive statistics (mean and percentage) by SPSS 18. Results: In general, 362 (88.8%) patients had color blindness. Out of 2052 male students and 2022 female ones, 343 (16.71%) and 19 (0.93%) cases were diagnosed with color blindness, respectively. In both genders, most students had deuteranopia or deuteranomalia, while other types of color blindness, including tritanomaly, were not detected in the students. Conclusion: The results of this study showed that the number of color blind people in the studied region was higher compared to the results of studies in the other regions of Iran. Moreover, the prevalence of color blindness was more in males compared to females. In addition, the prevalence of other kinds of color blindness mainly belonged to deuteranopia or deuteranomalia.

The effect of the ChromaGen contact lens system on visual performance

BACKGROUND

To evaluate the effects of the ChromaGen contact lens (CCL) on best-corrected visual acuity, contrast sensitivity and pseudoisochromatic test plate performance in patients with congenital colour vision deficiency (CVD).

METHODS

CCLs were inserted into 50 eyes of 25 patients with congenital red-green CVD. The patients were tested with the Ishihara and Hardy-Rand-Rittler test plates before and after the insertion of Magenta 2, Magenta 3, and Violet 3 CCLs. The patients' mean numbers of recognised symbols were calculated and the most appropriate CCL was determined for each eye. The best-corrected visual acuity for both far and near vision and contrast sensitivity were evaluated before and after the insertion of the appropriate CCLs, and the results were compared.

RESULTS

The mean age of the patients was 26.56 ± 10.30 years. While all CCLs increased the mean numbers of recognised symbols on the Ishihara (p < 0.001 for all), Magenta 3 was observed to be the most useful CCL. On the other hand, while all CCLs increased the mean numbers of recognised symbols on Hardy-Rand-Rittler (p < 0.001 for all), Magenta 2 and Magenta 3 were detected as the most useful CCLs. After insertion of the most appropriate CCL for each eye, the mean best-corrected visual acuity for both far and near vision were decreased (p < 0.001 for both). Statistically significant alterations were also detected at some spatial frequencies of contrast sensitivity measurements.

CONCLUSION

CCLs decrease the far and near best-corrected visual acuity, and static and dynamic contrast sensitivity at some spatial frequencies, and invalidate the pass criteria of pseudoisochromatic test plates by increasing the number of recognised symbols.

Prevalence and Determinants of Color Vision Defects among Preparatory University Students at Makkah, Saudi Arabia

PURPOSE

To estimate the magnitude and determinants of color vision defects (CVD) among preparatory health science students.

METHODS

A cross-sectional survey was conducted in 2017. Participants were assessed using 24-plate Ishihara's Test of Color Vision chart. If ≤9 plates were read correctly, the color vision was regarded as deficient. The CVD prevalence and its 95% confidence interval (CI) were calculated. CVD was associated with gender, family history of CVD, and other vision problems.

RESULTS

We evaluated 1126 students (552, 49% males; mean age: 18.7 ± 0.7 years). The prevalence of CVD was 1.77% (95% CI: 1.0, 2.6). Among male students, it was 3.5% (95% CI: 1.9, 5.0). Only one female student had CVD. The Duran CVD was found in 18 (1.6%) students. However, only two students had Tritan CVD. Three among twenty CVD students knew that they suffer from CVD. CVD was positively associated to a family history of CVD (odds ratio [OR] = 3.8; 95% CI: 1.4, 10.1;P = 0.02) and male gender (OR = 20.4 [95% CI: 2.7, 153]). CVD was not significantly associated to other vision problems (OR = 0.8 [95% CI: 0.3, 2.0]).

CONCLUSION

Eighteen in thousand health sciences students suffered from CVD. Ten percent of them had Tritan CVD. Duran CVD seems to be a male sex-related and/or a familial condition. Most of the CVD students seem to have adopted to this defect and were not aware of suffering from it. Screening for CVD is therefore debatable.

Blind to the risk: an analysis into the guidance offered to doctors and medical students with colour vision deficiency

BACKGROUND/OBJECTIVES

Doctors and medical students with colour vision deficiency (CVD) are less capable and less confident at identifying colour in a wide range of clinical scenarios, some of which could be potentially life-threatening. There have been numerous calls for screening and counselling over the last 25 years.

SUBJECTS/METHODS

Surveys were sent to all 33 UK medical schools and 154 acute trusts, to ascertain what screening and support exists for doctors with CVD. The response rate was 95%.

RESULTS

1.4% of acute trusts and 16.7% of medical schools screen for CVD. 3.4% of trusts and 10.0% of medical schools had CVD-specific advice which they give to medical professionals. Guidance and advice given varied widely between different schools and trusts.

DISCUSSIONS

Despite research showing a clear problem and lack of support for doctors with CVD, there has been a failure to respond by the medical profession. Screening, national guidance, counselling, and further research is needed to provide full support for practitioners with CVD and ensure patient safety.

Assessment of VINO filters for correcting red-green Color Vision Deficiency

In our ongoing research on the effectiveness of different passive tools for aiding Color Vision Deficiency (CVD) subjects, we have analyzed the VINO 02 Amp Oxy-Iso glasses using two strategies: 1) 52 observers were studied using four color tests (recognition, arrangement, discrimination, and color-naming); 2) the spectral transmittance of the lenses were used to model the color appearance of natural scenes for different simulated CVD subjects. We have also compared VINO and EnChroma glasses. The spectral transmission of the VINO glasses significantly changed color appearance. This change would allow some CVD subjects, above all the deutan ones, to be able to pass recognition tests but not the arrangement tests. To sum up, our results support the hypothesis that glasses with filters are unable to effectively resolve the problems related to color vision deficiency.

Prevalence of visual impairment among school children in three primary schools of Sekela Woreda, Amhara regional state, north-west Ethiopia

Background

Although there are limited studies, recent data are lacking to determine the prevalence of eye problems in Ethiopia accurately and there is no scientific evidence of such study in Sekela Woreda. The purpose of this study was to determine the prevalence of visual impairment among school children in Sekela Woreda, Ethiopia.

Methods

The study design was a community-based analytical cross-sectional with a multi-stage cluster random sampling technique from September to November 2016.Visual acuity was tested using Snellen's "E" chart while color vision was tested using Ishihara chart. The data were analyzed using SPSS version 20 software, and binary logistic regression was used to identify factors associated with visual impairment.

Results

A total of 875 participants, 466 (53.3%) males and 409 (46.7%) females, with an age range of 8-18 years were screened for visual acuity and color vision deficiency. The prevalence of visual impairment (visual acuity ⩽ 6/12) in "either eye" was 70 (8.0%). Among these, 37 (52.9%) were males and 33 (41.1%) were females. The prevalence of low vision (visual acuity ≤ 6 / 36 ) and blindness (visual acuity < 3/60) in "either eye" were 28 (3.2%) and 10 (1.1%), respectively. Thirty two (3.7%) had mild visual impairment ( v i s u a l a c u i t y ≤ 6 / 12 t o ≥ 6 / 18 ) . The prevalence of color vision deficiency was 36 (4.1%). Among these, 27 (3%) were males and 9 (1.1%) were females. The variables age (adjusted odds ratio (95% confidence interval) = 1.14 (1.01-1.28) and color blindness (adjusted odds ratio (95% confidence interval) = 3.93(1.69-9.09) were significantly associated with visual impairment.

Conclusion

The prevalence of blindness and low vision in school children were higher than the national prevalence in Ethiopia. Increasing age and color defective vision were factors associated with the children's visual impairment. The Woreda health office ought to work with responsible stakeholders to tackle the situation in early childhood.

Prevalence of congenital colour vision deficiency among Black school children in Durban, South Africa

Objectives

Congenital colour vision deficiency (CCVD) is an x-linked chromosome disorder that results from abnormalities in one or all three-cone type’s photoreceptors. Early assessment and diagnosis of CCVD is necessary to minimise the disability associated with the condition. Multistage sampling was used to determine the prevalence of CCVD among Black South African school children in Durban, South Africa. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy, auto-refraction, and examination of the anterior segment, media and fundus. Colour vision testing was performed using Colour Vision Testing Made Easy colour plates (Home Vision Care, Gulf Breeze, FL).

Results

1305 (704 boys and 601 girls) Black school children participated in the study. The overall prevalence of colour vision deficiency was 29 (2.2%), which was higher in boys (25, 4.2%) than girls (4, 0.6%), with prevalence of protanopia and deuteranopia found to be 10 (0.7%) and 19 (1.5%), respectively. The prevalence of protanopia and deuteranopia among males was nine (1.5%) and 16 (2.7%) respectively, which was significantly higher than the 1 (0.1%) protanopia and 3 (0.4%) deuteranopia in females (p < 0.05). Policies and guidelines for comprehensive school eye health programmes which screen children for CCVD are required in South Africa.

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4374-1) contains supplementary material, which is available to authorized users.

Image Content Enhancement Through Salient Regions Segmentation for People With Color Vision Deficiencies

Color vision deficiencies affect visual perception of colors and, more generally, color images. Several sciences such as genetics, biology, medicine, and computer vision are involved in studying and analyzing vision deficiencies. As we know from visual saliency findings, human visual system tends to fix some specific points and regions of the image in the first seconds of observation summing up the most important and meaningful parts of the scene. In this article, we provide some studies about human visual system behavior differences between normal and color vision-deficient visual systems. We eye-tracked the human fixations in first 3 seconds of observation of color images to build real fixation point maps. One of our contributions is to detect the main differences between the aforementioned human visual systems related to color vision deficiencies by analyzing real fixation maps among people with and without color vision deficiencies. Another contribution is to provide a method to enhance color regions of the image by using a detailed color mapping of the segmented salient regions of the given image. The segmentation is performed by using the difference between the original input image and the corresponding color blind altered image. A second eye-tracking of color blind people with the images enhanced by using recoloring of segmented salient regions reveals that the real fixation points are then more coherent (up to 10%) with the normal visual system. The eye-tracking data collected during our experiments are in a publicly available dataset called Eye-Tracking of Color Vision Deficiencies.