Abstract

Purpose: To screen for congenital color vision deficiency (CCVD) among newly admitted first-year medical students of Ain Shams University presenting for pre-enrollment health examination and to detect their awareness about deficiency if present.

Patients and Methods: A cross-sectional study design was adopted for 304 medical students (116 males and 188 females) before the first year in Ain Shams University. All of them underwent comprehensive eye examination and color vision testing using Ishihara pseudoisochromatic plates for screening of CCVD. All color deficient students were asked about their family history, awareness of their anomalous vision and its possible impact on future medical specialty.

Results: The overall prevalence of CCVD was 2.96%. It was found to be more in males (6.9%) than females (0.5%). Only 11% of the students having CCVD were aware of deficiency and 0% aware of its impact on the future medical specialty.

Conclusion: The male prevalence among medical students is close to highest reported in previous studies and awareness is low. Incorporation of CCVD screening in pre-enrollment examination for medical schools is essential to prevent struggle in education and future specialty selection.

Keywords: Color Vision Deficiency; Medical Specialty; Medical Students

References

1. Neitz M and Neitz J. “Molecular genetics of color vision and color-vision defects”. Archives of Ophthalmology 118 (2000): 691-700.
2. Deeb SS. “Molecular genetics of color-vision deficiencies”. Visual Neuroscience3 (2004): 191-196.
3. Wissinger B., et al. “Human rod monochromacy: linkage analysis and mapping of a cone photoreceptor expressed candidate gene on chromosome 2q11”. Genomics 51 (1998): 325-331.
4. Gardner JC., et al. “Blue cone monochromacy: causative mutations and associated phenotypes”. Molecular Vision 15 (2009): 876‐884.
5. Tagarelli A., et al. “Genetic, epidemiologic and social features of colour blindness”. Community Genetics1 (1999): 30‐35.
6. Johnston W., et al. “Observations on routine medical examinations of university entrants in Northern Ireland”. British Journal of Preventive and Social Medicine 3 (1957): 152‐161.
7. Ahlenstiel H. “Red-green Blindness as a Personal Experience”. Kodak Research Library (1951).
8. Logan JS. “The disability in so-called red-green blindness. An account based on many years of self-observation”. Ulster Medical Journal 46 (1977): 41-45.
9. Spalding JA. “The doctor with an inherited defect of colour vision: effect on clinical skills”. British Journal of General Practice 366 (1993): 32‐33.
10. Spalding JA. “Medical students and congenital colour vision deficiency: unnoticed problems and the case for screening”. Occupational Medicine (London) 4 (1999): 247‐252.
11. Campbell JL., et al. “The description of physical signs of illness in photographs by physicians with abnormal colour vision”. Clinical and Experimental Optometry 87 (2004): 334-338.
12. Campbell JL., et al. “Doctors and the assessment of blood glucose testing sticks: does colour blindness matter?” British Journal of General Practice454 (2000): 393‐395.
13. Campbell JL., et al. “The effect of abnormal colour vision on the ability to identify and outline coloured clinical signs and to count stained bacilli in sputum”. Clinical and Experimental Optometry 6 (2005): 376-381.
14. Spalding JAB. “Doctors with inherited colour vision deficiency: their difficulties in clinical work”. In: Cavonius CR, ed. Proceedings of the International Research Group for Colour Vision Deficiency. Dordrecht: Kluwer International Publishing (1995): 483-489.
15. Winston JV., et al. “Computer analysis of Farnsworth-Munsell 100-hue test”. Ophthalmic and Physiological Optics 7 (1987): 267-280.
16. Knoblauch K. “On quantifying the bipolarity and axis of the Farnsworth-Munsell 100-Hue test”. Investigative Ophthalmology and Visual Science 28 (1987): 707-710.
17. Patel JR., et al. “Assessment of colour vision deficiency in medical students”. International Journal of Community Medicine and Public Health 1 (2016): 230-235.
18. Pramanik T., et al. “Color vision deficiency among a group of students of health sciences”. Nepal Medical College Journal 4 (2012): 334-336.
19. Dohvoma VA., et al. “Color vision deficiency among biomedical students: a cross-sectional study”. Clinical Ophthalmology 12 (2018): 1121‐1124.
20. Rivers WHR. “The colour vision of the natives of upper Egypt”. Journal of the Anthropological Institute of Great Britain and Ireland 31 (1901): 229-247.
21. Semary NA and Marey H. "An evaluation of computer based color vision deficiency test: Egypt as a study case". 2014 International Conference on Engineering and Technology (ICET), Cairo (2014).
22. El-Toukhy A., et al. “Prevalence of color vision deficiency among dental students in Alexandria, Egypt”. Egyptian Dental Journal 62 (2016): 487-492.
23. Osuobeni EP. “Prevalence of congenital red-green color vision defects in Arab boys from Riyadh, Saudi Arabia”. Ophthalmic Epidemiology 3 (1996): 167-170
24. Al-Aqtum MT and Al-Qawasmeh MH. “Prevalence of color blindness in young Jordanians”. Ophthalmologica 215 (2001): 39-42.
25. Dargahi H., et al. “Color Blindness Defect and Medical Laboratory Technologists: Unnoticed Problems and the Care for Screening”. Acta Medica Iranica 48 (2010): 172-177.
26. Mitiku RG., et al. “Prevalence and allele frequency of Congenital Colour Vision Deficiency (CCVD) among students at Hawassa University, Ethiopia”. Journal of the Egyptian Public Health Association10 (2020).
27. Malaspina P., et al. “Color blindness distribution in the male population of Rome”. Human Hereditary 36 (1986): 263-265.
28. Norn M. “Prevalence of congenital color blindness among Inuit in East Greenland”. Acta Ophthalmologica Scandinavica 75 (1997): 206-209.
29. Grosvenor T. “The incidence of red-green color deficiency in New Zealand’s Maoris and “Islanders”. American Journal of Optometry and Archives of American Academy of Optometry 6 (1970): 445-450
30. Rebato E and Calderon R. “Incidence of red/green color blindness in the Basque population”. Anthropologischer Anzeiger 48 (1990): 145-148.
31. Mitchell RJ. “Red green color blindness in the Isle of Man and Cumbria”. Annals of Human Biology 4 (1977): 577-579.
32. Pap M., et al. “Frequency of red/green color blindness in twenty-seven Hungarian populations”. Journal of Human Evolution 12 (1983): 775-778.
33. Kim HB., et al. “The incidence of congenital color deficiency among Koreans”. Journal of Korean Medical Science 4 (1989): 117-120.
34. Panat Arun and Kulkarni D. “Prevalence of red-green color vision deficiency (cvd) among science students: a 10 years' survey”. Human Biology Review 5 (2016).
35. Qian YS., et al. “Incidence of myopia in high school students with and without red-green color deficiency”. Investigative Ophthalmology and Visual Science 50 (2009): 1598-1605.
36. Cumberland P., et al. “Impact of congenital color vision deficiency on education and unintentional injuries: findings from the 1958 British Birth Cohort”. BMJ 329 (2004): 1074-1075..
37. Davison SP and Mysilinski NR. “Shade selection by color vision defective dental personnel”. Journal of Prosthetic Dentistry 63 (1990): 97-101.
38. Nathans J., et al. “Molecular genetics of inherited variation in human colour vision”. Science4747 (1986): 203-210.
39. Mann I and Turner C. “Color vision in native races in Australasia”. American Journal of Ophthalmology 41 (1956): 797-800.
40. Mughal IA., et al. “Colour vision deficiency (CVD) in medical students”. Pakistan Journal of Physiology1 (2013): 14-16.
41. Harris RW and Cole BL. “Diagnosing protan heterozygosity using the Medmont C-100 colour vision test”. Clinical and Experimental Optometry 88 (2005): 240-247.
42. Pitt F H G. “Monochromatism”. Nature154 (1944): 466-468.
43. Weale R A. “Cone monochromatism”. Journal of Physiology I2I (1953): 548-569.
44. Logan JS. “The disability in so called red green blindness. An account based on many years of self observation”. Ulster Medical Journal 46 (1977): 41-45.
45. Rigby HS., et al. “Color perception in pathologists: the Farnsworth-Mansell 100-hue test”. Journal of Clinical Pathology 44 (1991): 745-748.
46. Poole CJ., et al. “Deficient color vision and interpretation of histopathology slides: cross sectional study”. BMJ 315 (1997): 1279-1281.
47. Cockburn DM. “Confessions of a color blind optometrist”. Clinical and Experimental Optometry 87 (2004): 350-352.
48. Raynor NJ., et al. “Blind to the risk: an analysis into the guidance offered to doctors and medical students with colour vision deficiency”. Eye (London)12 (2019): 1877-1883.
49. National Patient Safety Agency. “Patient safety alert: reducing the harm caused by misplaced nasogastric feeding tubes” (2005).