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Jeung Kim, Trent Gaasch, Andrew Shum; Comparison of the electronic versions of Ishihara pseudochromatic plates with the printed version. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5597.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if the electronic versions of Ishihara plates, either smartphone app or online version, elicit the same response (i.e. plate number identification) as a traditional printed copy of the Ishihara test when performed on color normal and red-green color deficient individuals
24 participants were recruited among faculty and students in a post-graduate school (Memphis, TN). A printed Ishihara test booklet was used under standardized test conditions and served as a control for the study. Electronic versions of the same plates, including 14 screening plates, were downloaded and set up on an iPhone 4s and a Macbook Pro. Both electronic devices were normalized to mimic the same luminance and retinal visual angle as the booklet. Each plate on electronic devices was presented to subjects in randomized order. The color vision status of each participant was confirmed with an HMC anomaloskop. Two examiners performed all testing and collected data independently. The plate number reported by each subject was compared between the color vision normal group to those of the protan and deutan defects.
Of the 24 participants in the study, 13 were given an anomaloscope diagnosis of color vision normal, 6 of a deutan defect, 4 of a protan defect, and 1 of an uncategorized anomaly. Color vision normal participants showed very similar results between the printed copy and the Macbook Pro, with an average of 0.08 ± 0.27 plates reported differently, while 0 difference was shown between the printed copy and the iPhone 4s. Deutan defects showed a statistically significant difference between the printed copy and the Macbook Pro, with an average of 5.58 ± 1.73 plates reported differently, while an average of 5.67 ± 1.92 plates were reported differently with the iPhone 4s. Protan defects showed a statistically significant difference between the printed copy and the Macbook Pro, with an average of 6.75 ± 1.75 plates reported differently, while an average of 7.125 ± 1.36 plates were reported differently with the iPhone 4s.
The electronic versions of the plates available on the internet and in color vision apps for smartphones result in improper representation of Ishihara testing results, even in a testing environment best mimicking a standardized condition for Ishihara booklet. Further evaluation and adjustment are required to make these electronic versions viable alternatives.
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