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Michele E. Mercer, Russell J. Adams; Direct Comparison of Current Pediatric Pseudoisochromatic Color Vision Tests in Preschool Children. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5637.
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In the routine ophthalmic evaluation of individual children or within more formal mass pediatric eye and vision screening programs, assessment of early color vision is rarely conducted. This is partly because color vision is considered by some to be a secondary visual function, but perhaps more so, because there is no consensus among practitioners as to the optimal test. To address the latter issue, we compare directly, the efficiency and suitability of all of the existing preschool-oriented pseudoisochromatic color vision tests.
85 healthy 3-5 year-old children (44 males,41 females) were tested with the experimental Pease-Allen Color Test (PACT), as well as with the 3 most widely available commercially available pediatric tests of color vision: the Ishihara plates(child version), the Hardy Rand Rittler (HRR) plates, and the Color Vision Test Made Easy (CVTME). Monocular visual acuity and non-cycloplegic refractive error were also assessed in most children.
76% of the children completed all 4 tests, in an average time of 1.1 min (PACT), 3.3 min (CVTME), 4.1min (Isihara), and 4.5 min (HRR), respectively. Completion rates were highest for the PACT (100%), followed by the CVTME (95%), and less so for the HRR and the Ishihara (79% and 78%). Experimenter ratings of ease of administration and response confidence mirrored these completion rate data. Those children who failed (7 boys, 1 girl) did so consistently across all 4 tests. All failures indicated a red/green color/deficiency and among those tests which differentiate R/G failures into protanopic and deuteranopic, all tests indicated the same subtype of deficiency.
Although they differ somewhat in design, there is remarkable consistency among pseudoisochromatic tests of color vision administered to young children. The PACT is especially easy and quick to administer although interpretations are limited to either R/G or B/Y deficiencies, with no subtype distinction possible. Among the more extensive tests, the CVTME appears to be the easiest and quickest to administer. Moreover, given the importance of color in a young child’s environment, our results suggest that color testing can be easily incorporated into most eye/vision screening programs for the identification of congenital, acquired, and acute color vision deficiencies, and to also serve as a marker of color - related neurological and systemic diseases.
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