Visual acuity and color discrimination in patients with cataracts

Modeling D15 test sequences in red-green anomalous trichromacy

Color arrangement tests such as the D15 test can be used to detect congenital and acquired color vision defects. However, the D15 test cannot be used as the only test to assess color vision because of its relatively low sensitivity in less severe cases of color vision deficiency. In this study, we attempted to determine D15 cap arrangements for red/green anomalous trichromats with varying degrees of severity of color vision deficiency. The color coordinates of D15 test caps corresponding to a particular type and severity of color vision deficiency were determined using the model proposed by Yaguchi et al. [J. Opt. Soc. Am. A35, B278 (2018)JOAOD60740-323210.1364/JOSAA.35.00B278]. The arrangement of the color caps was modeled by assuming that individuals with color vision deficiency would arrange the D15 test caps judging by color differences perceived by them. The proposed simulation correctly predicts the increase in severity of color vision deficiency with spectral reduction between the L- and M-cone photopigments. The type of color vision deficiency is correctly predicted with few exceptions in protanomalous trichromats.

Evaluation of color vision related quality of life changes due to cataract surgery

Questionnaires have been used as research tools to provide a standardized approach to assess quality of life at various time periods and populations. However, literature shows only a few articles about self-reported color vision changes. Our aim was to evaluate the subjective patient feelings before and after cataract surgery and compare the results with a color vision test result. Our method was as follows: 80 cataract patients filled out a modified color vision questionnaire and performed the Farnsworth-Munsell 100 Hue Color Vision Test (FM100) before, two weeks, and six months after cataract surgery. We analyzed the correlations between these two types of results, which reveal that FM100 hue performance and subjective perception improved after surgery. Additionally, subjective patient questionnaire scores correlate well with the FM100 test results before and two weeks after the cataract surgery, but this effect decreased with longer follow-up times. We conclude that subjective color vision changes can only be noticed at longer periods after the cataract surgery. Health care professionals can use this questionnaire to better understand the subjective feelings of patients and monitor their color vision sensitivity changes.

The Effects of a Blue-Light Filtering Versus Clear Intraocular Implant on Color Appearance

Purpose

More than a dozen studies have investigated whether blue-light filtering (BLF) intraocular lens (IOL) implants influence color vision, generally finding they do not. These studies have not tested color vision per se; rather, they have measured color vision deficiencies or chromatic discrimination. Here, we used additive trichromatic colorimetry to assess color appearance in participants with BLF and clear IOL.

Methods

Seventy-six participants were recruited from two populations: older participants (n = 52) with BLF and clear IOL (n = 98 eyes; M = 67.33 ± 7.48 years; 58.8% female; 25.5% non-White), and young adult control participants (n = 24; M = 21.0 ± 5.13 years; 70.8% female; 41.5% non-White). Participants used a custom-built tricolorimeter to mix three primaries until a perceived perfect neutral white was achieved. Color appearance, expressed as chromaticity coordinates, was measured with a spectral radiometer (ILS950).

Results

Between subjects, the BLF IOL chromaticity coordinates (x = 0.34, y = 0.35, u′ = 0.21, v′ = 0.48) were not significantly different from the clear IOL (x = 0.34, y = 0.33, u′ = 0.22, v′ = 0.48). BLF and clear IOL were also not different within-contralateral subjects (n = 21; BLF x = 0.34, y = 0.33, u′ = 0.22, v′ = 0.47; clear x = 0.34, y = 0.33, u′ = 0.21, v′ = 0.48). Both IOL groups differed from young adults (v′[0.45; P = 0.001], x[0.31; P = 0.008], and y[ 0.30, P < 0.000], but not u′[0.21]).

Conclusions

One advantage of geometric representation of color space is the ability to specify the appearance (rather than spectral composition) of any light mixture by specific coordinates. Using this system, only minor differences in color appearance were found between a BLF, clear IOL, and young natural lens.

Translational Relevance

When color perception is directly measured, the BLF and clear IOL are not meaningfully different.

Application of Blue Filters Increases the Usefulness of Moreland Test in Anomaloscopic Color Vision Assessment for Blue-Green Color Range

The effect of blue light filters on the anomaloscopic examination was analyzed. Thirty subjects (18–43 y, 20 female, 10 male) without color vision disorders were examined in 4 filter conditions: no filter (F-0), Blue Control Hoya (F-BC), Med-1 JZO (F-Med1) and 450 Eschenbach (F-450). Both Rayleigh test (red–green axis) and Moreland test (blue–green axis) were performed. Application of F-BC filter shows negligible effect on color vision perception in both tests. Contrary to this, the application of strong F-450 filter causes significant shift in Moreland test towards tritanopy and the decrease in correlations of Moreland parameters with Rayleigh test parameters. The application of medium strong F-Med1 filter causes the slight shift in Moreland test towards the center of the Moreland scale and increases the Spearman correlations between Moreland and Rayleigh test parameters. This observation suggests that the about 15–40% reduction of blue diode intensity in the Moreland test may be beneficial in detecting mild changes in color vision perception in the blue-green axis and may improve its usefulness in evaluating the color vision perception disorders accompanying different illnesses, such as diabetes, glaucoma, neuritis optica, or cataract. The discussion concerning the modifications of Moreland test construction is also presented.

Variability of Rayleigh and Moreland test results using anomaloscope in young adults without color vision disorders

Aim

To validate the reference ranges proposed by the manufacturer of the Oculus HMC Anomaloscope MR for Rayleigh and Moreland tests in healthy young adults.

Method

The manual Rayleigh (red-green) and the Moreland (blue-green) anomaloscope tests were performed on 90 healthy subjects (54 female, 36 male, 178 eyes) residing in Poland, aged between 18–45 years, and without color vision disorders (assessed with HRR test). The analyzed parameters for both the Rayleigh and the Moreland tests were as follows: the lower (R₁/M₁) and the upper (R₂/M₂) limits; the center (R_C/M_C) and the width (R_W/M_W) of the matching ranges.

Results

The results of the Rayleigh test were similar to the values proposed in the anomaloscope user’s manual, however, with a small shift of R_C and R₂ towards the red color. The double-peak distribution of R₂ with a small second peak (approximately at R₂ = 52) was mainly due to the measurements in male subjects (n_male = 8, n_female = 2), which suggests that this group might be diagnosed with subtle protanomaly. The results of the Moreland test showed a high M_W which did not correspond to the reference range described in the anomaloscope user’s manual. The observed significant correlations between R₁ and M₁ suggest that the M₁ parameter seems to be the best indicator of blue vision quality.

Conclusions

Oculus HMC Anomaloscope MR is a sensitive tool for detection of prot-deuteranomalies but the reference ranges for young adults require a certain adjustment towards the red color. The parameters obtained for the Moreland test varied significantly between the subjects and therefore the test should not be used as is to diagnose color vision deficits in the green-blue area (tritanomaly).