Research Article
Volume 12 Issue 1 - 2021
Prevalence and Awareness of Congenital Color Vision Deficiency during Pre-Enrollment Screening of Medical Students of Ain Shams University in Egypt: A Cross-sectional Study
Esraa A Ramadan1*, Hassan A El Sayed2, Abd El Rahman G Salman2, Shaker A Khedr2, Khaled M Abd Elaziz3 and Mohammad A Rashad2
1Ophthalmology Department, Memorial Institute for Ophthalmic Research, Egypt
2Ophthalmology Department, Faculty of Medicine, Ain Shams University, Egypt
3Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt
*Corresponding Author: Esraa A Ramadan, Ophthalmology Department, Memorial Institute for Ophthalmic Research, Egypt.
Received: September 29, 2020; Published: December 31, 2020


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


  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).
Citation: Esraa A Ramadan., et al. “Prevalence and Awareness of Congenital Color Vision Deficiency during Pre-Enrollment Screening of Medical Students of Ain Shams University in Egypt: A Cross-sectional Study”. EC Ophthalmology 12.1 (2021): 41-50.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to