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Background: Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD affects diagnostic accuracy and distinguish between malignant choroidal melanoma and benign choroidal nevus among ophthalmologists. Methods: In this cross-sectional study, we engaged ophthalmologists through a web-based survey distributed via the professional ophthalmology society's social media channels. The survey encompassed a series of three fundus images representing normal fundus, choroidal nevus, and choroidal melanoma. Each image underwent simulation for the three primary types of CVD-protanopia, deuteranopia, and tritanopia-alongside a non-simulated version. Results: The study included 41 participants, averaging 40 years of age (±9.2), comprising 28 (68%) men and 13 (32%) women. Significantly lower rates of identifying orange pigments were observed in simulated protanopia images compared to non-simulated ones (p = 0.038). In simulated deutranopia images, the recognition of melanotic lesions was notably reduced compared to non-simulated images (p = 0.048). No such limitation was observed for tritanopia. However, participants retained their ability to identify subretinal fluid and estimate tumor thickness in simulated and non-simulated images. Concerning simulated images of choroidal nevi, participants misdiagnosed nevi as choroidal melanoma in 37% of cases in simulated protanopia nevi images and 41% in simulated deutranopia nevi images. This resulted in unnecessary referrals of benign lesions as malignant, emphasizing the potential for mistaken diagnoses. Nevertheless, almost all simulated images of malignant melanoma were correctly referred for specialized oncological treatment. Conclusions: The simulated CVD conditions of protanopia and deuteranopia affected the accuracy of identifying the melanotic nature of the choroidal tumor and the presence of orange pigments. This limitation led to challenges in correctly diagnosing choroidal melanoma and choroidal nevus, resulting in extra referrals for nevus cases. However, participants were safe and could still determine the possible risk of eyes with choroidal melanoma, so most referred melanoma cases to specialized oncologists as needed.

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AIM: To determine the prevalence of red-green (RG) color vision deficiency (CVD) in an elderly population and its related factors. METHODS: This report is a part of the Tehran Geriatric Eye Study: a cross-sectional population-based study that was conducted on the elderly population (≥60y) of Tehran, Iran using multi-stage stratified random cluster sampling. All study participants underwent complete ocular examination, including the measurement of uncorrected and best-corrected visual acuity, objective and subjective refraction, and slit-lamp biomicroscopy. The color vision was tested using Ishihara plates with the near optical correction in place. RESULTS: Of the 3791 invitees, 3310 participated in the study. The data of 2164 individuals were analyzed after applying the exclusion criteria. The prevalence of R-G CVD was 3.73% (95%CI: 2.37%-5.09%) in the whole sample; the prevalence of protanomaly, protanopia, and deuteranopia was 1.51%, 1.76%, and 0.45%, respectively. The prevalence of R-G CVD was significantly higher in males than in females. The prevalence of RG CVD increased with advancing age from 2.91% in the age group 60-64y to 5.8% in the age group ≥80y (P=0.070). According to the multiple logistic regression model, male sex, and glaucoma were significantly related to RG CVD. Older age and hypertension also had a marginally significant relationship with RG CVD. CONCLUSION: Changes in color vision occur in the elderly due to the aging process and some physiological and pathological factors. Since the change in visual perception may affect the person's performance, this aspect of the visual system's function should also be taken into consideration in the examinations of the elderly.

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Background and objective Color vision abnormality is a condition where the faculty to identify one or more primary colors is either defective (anomalous) or absent (anopia). Occupations like armed forces, merchant navy, navigation, and police and fire services require normal color vision. There is a scarcity of data in the literature regarding the prevalence of congenital color vision abnormality in patients in South India. In light of this, the present study aimed to find the prevalence of congenital color vision abnormality in patients attending the Outpatient Department (OPD) at a tertiary eye care center in South India. Materials and methods This was a descriptive cross-sectional study conducted at a tertiary eye care center in South India from December 2014 to December 2016. Patients with a best-corrected visual acuity of 20/20, normal direct and consensual pupillary light reflex, normal anterior segment, and undilated fundus examination were included. Color vision was assessed using Ishihara pseudoisochromatic plates, American Optical Hardy-Rand-Rittler (AO HRR), and then the Farnsworth Munsell D15 arrangement test. All the results were tabulated and statistically analyzed. Statistical significance was calculated using the ANOVA test. Results A total of 371 patients were screened for color vision abnormality; 184 (49.59%) patients were males and 187 (50.40%) were females. Out of 371 patients in the study, 363 (98.10%) had normal color vision while eight patients (2.16%) had color vision abnormality. Of the eight patients with color vision abnormalities, six (75%) had abnormal color vision on all three tests and two (25%) had an abnormality on only two tests (Ishihara and AO HRR). Out of 184 males in the study, eight patients (4.34%) had abnormal color vision while none of the 187 females had color vision abnormality; this difference was statistically significant (p=0.03). Conclusions Early diagnosis and providing education and awareness of this condition are necessary as part of guiding young people with regard to their career options and we recommend that all children should undergo color vision screening before entering high school.

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BACKGROUND: Color vision deficiency (CVD) is an under-reported problem among medical personnel, and its impact is still not well characterized. We aim to assess the impact of CVD among ophthalmologists on the accuracy of diagnosing different benign and malignant choroidal lesions. METHODS: This is a cross-sectional study conducted on ophthalmologists. We used a web-based survey to collect responses through professional ophthalmology society social media. The survey included a set of five images for normal fundus, choroidal nevus, circumscribed choroidal hemangioma, choroidal metastasis, and choroidal melanoma, wherein each image simulated the three main types of CVD: protanopia, deuteranopia, and tritanopia, in addition to a non-simulated image. RESULTS: Forty-one participants were included, with a mean age of 40 (±9.2) years. They were 28 (68%) men and 13 (32%) women. Participants showed significantly low accuracy for definite diagnosis for circumscribed choroidal hemangioma, nevus, melanoma, and metastasis when the images simulated protanopia and deuteranopia, but not tritanopia. Nevertheless, participants maintained the capability to recognize the nature of the lesions for both simulated and non-simulated images if they were benign or malignant, thereby ensuring immediate referral for specialized care. The exception was with simulated choroidal nevi images, wherein participants incorrectly assigned simulated protanopia and deuteranopia nevi images to malignant lesions. CONCLUSION: Protanopia and deuteranopia affected the accuracy of diagnosing several choroidal lesions; however, ophthalmologists with those two simulated CVDs were still able to discriminate between benign and malignant tumors.

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Background: Bornholm eye disease (BED) is a rare X-linked cone dysfunction disorder with high myopia, amblyopia, and color vision defects.Materials and methods: Visual and ocular outcomes in a family where two of five siblings had molecularly confirmed BED are reported. Ophthalmological assessments included best-corrected visual acuity (BCVA), color vision test, and optical coherence tomography (OCT). Medical records, electroretinography (ERG), and genetic analyses were re-evaluated.Results: Two male siblings had confirmed BED with myopia and protanopia. The younger brother had high myopia, subnormal BCVA, and ocular fundi that showed tilted discs, crescent shaped peripapillary atrophy, and visible choroidal vessels. OCT confirmed retinal and choroidal atrophy. The older brother was lightly myopic with normal/subnormal BCVA and subtle findings in the fundi. Both brothers had abnormal ERG recordings with a decreased cone response. They also had a structurally intact OPN1LW/OPN1MW gene cluster. The OPN1LW gene was shown to carry a deleterious variant combination in exon 3 known to result in mis-splicing of opsin mRNA and acknowledged as LIAVA amino acid delineation (Leu153-Ile171-Ala174-Val178-Ala180), while the OPN1MW gene exon 3 showed a non-pathogenic variant combination (MVVVA). Another normal-sighted brother carried another wildtype variant combination (LVAIS) in exon 3 of the OPN1LW gene.Conclusions: The two affected brothers demonstrated a large variability in their phenotypes even though the genotypes were identical. They presented a disease-associated haplotype in exon 3 of OPN1LW that has been described as the molecular cause of BED.

Asunto(s)

Ambliopía/genética , Defectos de la Visión Cromática/genética , Exones/genética , Enfermedades Genéticas Ligadas al Cromosoma X/genética , Miopía Degenerativa/genética , Miopía/genética , Opsinas de Bastones/genética , Agudeza Visual/fisiología , Adolescente , Ambliopía/diagnóstico , Ambliopía/fisiopatología , Percepción de Color/fisiología , Pruebas de Percepción de Colores , Defectos de la Visión Cromática/diagnóstico , Defectos de la Visión Cromática/fisiopatología , Electrorretinografía , Enfermedades Genéticas Ligadas al Cromosoma X/diagnóstico , Enfermedades Genéticas Ligadas al Cromosoma X/fisiopatología , Humanos , Masculino , Miopía/diagnóstico , Miopía/fisiopatología , Miopía Degenerativa/diagnóstico , Miopía Degenerativa/fisiopatología , Fenotipo , Retina/fisiopatología , Perfil de Impacto de Enfermedad , Tomografía de Coherencia Óptica , Campos Visuales/fisiología , Adulto Joven

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Colours and emotions are associated in languages and traditions. Some of us may convey sadness by saying feeling blue or by wearing black clothes at funerals. The first example is a conceptual experience of colour and the second example is an immediate perceptual experience of colour. To investigate whether one or the other type of experience more strongly drives colour-emotion associations, we tested 64 congenitally red-green colour-blind men and 66 non-colour-blind men. All participants associated 12 colours, presented as terms or patches, with 20 emotion concepts, and rated intensities of the associated emotions. We found that colour-blind and non-colour-blind men associated similar emotions with colours, irrespective of whether colours were conveyed via terms (r = .82) or patches (r = .80). The colour-emotion associations and the emotion intensities were not modulated by participants' severity of colour blindness. Hinting at some additional, although minor, role of actual colour perception, the consistencies in associations for colour terms and patches were higher in non-colour-blind than colour-blind men. Together, these results suggest that colour-emotion associations in adults do not require immediate perceptual colour experiences, as conceptual experiences are sufficient.

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A close relationship has been shown to exist between the second stage of the Müller theory and the MacAdam 1937 (u, v)-diagram recommended in 1960 by the CIE for interim use as a chromaticity diagram having approximately uniform scales. By considering normal vision as a combination of protanopia and tritanopia as suggested by the Müller second stage, a more general measure of the perceived size of a chromaticity difference is developed than the length of the line connecting the two chromaticity points. The general measure is the square root of the sum of the squares of the angles subtended by the line at the convergence points of the chromaticity confusion lines for protanopia and tritanopia, respectively. By this measure the chromatic sensibility to wavelength change in the spectrum is accounted for quantitatively not only for protanopic and tritanopic vision, but also for normal vision including the secondary maximum of sensibility in the neighborhood of 420 nm.