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Janis Winters, Tracy Matchinski, Karen Squier; Acquired color vision deficiency among visually impaired adults attending a vision rehabilitation clinic. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4161.
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Visually impaired (VI) patients have significant ocular disease and therefore may have acquired color vision defects (CVD). Color vision (CV) testing however may be limited among VI patients since anecdotal evidence suggests VI patients have difficulty with pseudoisochromatic plate tests assessing acquired CVD. These testing limitations may have led to the scarcity of reports on CV testing and CVD prevalence among VI patients in vision rehabilitation clinics (VRC). The purpose of this study is to assess moderate/ severe CVD among VI patients attending a VRC clinic and trends related to symptomology, level of VI and ocular diagnosis.
Patients attending a VRC were surveyed regarding CV. CV was tested using the 1.3 inch stimulus size ‘Panel 16 Quantitative Color Vision Test’ (D-15) and the Richmond Daylight Illuminator. Patients were classified as CVD if there were 2 or more major crossover errors in either eye on the D-15. Patients assessed as ‘likely congenital CVD’ were excluded (N=2). VI was classified using World Health Organization criteria. For VI classification, VA in the eye with CVD or ‘better seeing’ eye (if both CVD), was used. Primary cause of VI was sub-classified into optic nerve or retina.
Range of VAs for those who completed D-15 testing (N=84) was 20/20- 20/3000. Mean age was 53 yrs. Nearly half of patients tested (48.8% (N=41)) were classified as CVD. Type of CVD could not be assessed in the majority. Change in CV was reported by 35% with CVD and 13% non-CVD. CVD was assessed in 52% of those with optic nerve disease and 61% of those with retinal disease. Level of VI among those CVD was 17% normal/near normal, 44% moderate impairment and 39% severe impairment/worse.
D-15 testing was completed on patients with a wide range of VI levels; demonstrating the feasibility of this method of color vision assessment in a VRC clinic. There was a high percentage of moderate/severe CVD identified among adults studied. Of those with CVD, there was variability in report of change in CV, level of VI and ocular disease causing VI. Therefore in this population CVD cannot be assumed based upon these factors. Although there is no treatment for CVD, education about acquired CVD and specific activities CVD may impact is essential especially due to possible CVD progression as the ocular conditions worsen.
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