Is screening for congenital colour vision deficiency in school students worthwhile? A review a

Abstract

This review analyses the literature on screening for congenital colour vision deficiency in school students, which predominantly uses the Ishihara test. The review was framed with respect to the established Wilson and Jungner criteria for screening programs. These criteria relate to the characteristics of the condition concerned, the performance of the screening test, the existence of treatment options and the performance of screening programs.

The literature reviewed suggests that congenital colour vision deficiency has not been shown to increase risk of road traffic crashes and is not a preclusion to driver licensing in most developed countries. The occurrence of congenital colour vision deficiency has been used to limit entry into certain occupations; however, the value of screening school students with regard to occupational preclusion is questionable. Stronger evidence exists indicating no association between congenital colour vision deficiency and level of educational achievement. Studies showing any association between congenital colour vision deficiency and other health and lifestyle impacts were rare. The most commonly used screening test (using Ishihara pseudoisochromatic plates) performs well with respect to detecting red‐green colour vision deficiencies. Finally, the only interventions we identified for congenital colour vision deficiency were management ones around the availability of specific tinted lenses and computer programs to aid colour perception in certain tasks.

Given this picture, the weight of evidence appears to be in favour of not adopting (or discontinuing) routine colour vision screening programs for school students; however, it may be worthwhile for a career advisor to refer school students to an optometrist or ophthalmologist for colour vision screening, upon expression of interest in an occupation where normal colour vision is either particularly desirable or is a regulatory requirement.

Key words:

• children's vision
• congenital colour vision
• Ishihara pseudoisochromatic plates
• school vision screening programs
• screening
• students

Part of this work was published as an abstract in the Proceedings of the RANZCO New Zealand Branch Annual Meeting May 3–4, 2013 in Auckland, New Zealand. Available from: http://fp2.brandish.co.nz/ranzco2013/files/RANZCO‐prog_sr1.pdf.

Part of this work was published as an abstract in the Proceedings of the RANZCO New Zealand Branch Annual Meeting May 3–4, 2013 in Auckland, New Zealand. Available from: http://fp2.brandish.co.nz/ranzco2013/files/RANZCO‐prog_sr1.pdf.

Acknowledgements

The authors wish to thank the reviewers, the Associate Editor and the Editor in Chief of the journal for their helpful comments on the manuscript.

The lead author (NR) was funded by a grant from Mr Dick Georgeson (as a contribution to eye health research) and the Wellington Medical Research Foundation. The financial supporters had no role in the design or writing of this article.

Notes

Part of this work was published as an abstract in the Proceedings of the RANZCO New Zealand Branch Annual Meeting May 3–4, 2013 in Auckland, New Zealand. Available from: http://fp2.brandish.co.nz/ranzco2013/files/RANZCO‐prog_sr1.pdf.

Additional information

Funding

Wellington Medical Research Foundation