THE ARMY COLOR VISION STUDY

INTRODUCTION: Color vision deficiency is a common disqualifying factor for certain occupations in the US Army. Tactical displays use color coding as a friend/foe discriminator, which stresses the importance of normal color discrimination. New display technologies demand that personnel color vision standards remain task relevant. The ultimate goal is to provide recommendations for a color vision test that is quick to administer, easy to interpret, and able to accurately classify and quantify color deficiencies. METHODS: A battery of color vision tests were administered to 42 color vision normal (CVN) and 39 color vision deficient (CVD; 26 deutan and 13 protan) Soldiers. The color vision test battery included: Dvorine pseudoisochromatic plates (PIP), Standard PIP 2 (SPP2); PIP Ishihara Compatible (PIPIC); Hardy Rand and Ritter (HRR) PIP, 4th Edition; Farnsworth Lantern (FALANT); Farnsworth D-15 (D15); Colour Assessment & Diagnosis (CAD) test, and the Cone Contrast Test (CCT). All tests were administered monocularly following the manufacturer's instructions. The sensitivity and specificity of each test were determined using the anomaloscope as the gold standard. RESULTS: The sensitivity and specificity, respectively, for detection of color perception were high for: PIPIC (1.0; 1.0); Dvorine PIP (1.0; 0.98), HRR (0.97; 0.93); SPP2 (0.89; 1.0); and FALANT (0.86; 0.95). The D-15 had the lowest sensitivity (0.36; 1.0). The sensitivity and specificity for detection and categorization of color deficiencies were higher for the CCT (1.0; 1.0) than for the CAD (0.94; 0.89), when compared to the anomaloscope. The average administration time for the CCT and CAD tests were 6 and 25.5 min, respectively. DISCUSSION: When properly administered, the PIPC and the Dvorine PIP have the highest sensitivity and specificity as screening tests for color vision. The CCT has the highest sensitivity and specificity as well as the shortest administration time for detection and categorization of color vision perception.