Dalton's pseudo-isochromatic plates and congenital colour vision deficiency

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BackgroundDiagnosing colour vision deficiency is vital, owing to its impact on the choice of career and activities of daily living. Conventional screening methods require frequent replacement due to soiling of the materials, and hence are expensive and not feasible for large-scale community screening. This study aims to construct and validate a new screening tool, Dalton's pseudo-isochromatic plates (PIP), addressing the disadvantages of the conventional methods.MethodsThe two phases of the study included the construction and validation of the Dalton's PIP. Construction involved utilising specific wavelengths based on spectral tuning, selection of numerals as targets for the chart and identification of a material with durability and resistance to wear and tear. Validation of the chart was done against the 38-plate edition of Ishihara's PIP by two masked examiners for 1,019 school children aged between 11–17 years (mean ± SD: 14 ± 2 years) as part of a school eye-health program.ResultsThe sensitivity and the specificity of the Dalton's PIP was found to be 94.12 per cent (95% CI 71.31–99.85) and 99.60 per cent (95% CI 98.98–99.89) respectively and the positive and negative predictive values were 80 per cent and 99.90 per cent respectively. Dalton's PIP when used with a failure criterion of less than three plates correct in two screening sets had the maximum sensitivity and specificity and the area under the curve was 0.96 (95% CI 0.90–0.99, p < 0.05).ConclusionThe newly constructed Dalton's PIP is found to be a valid screening tool to detect congenital colour vision deficiency and is comparable to the Ishihara PIP. This screening tool with its shorter screening time, cost and longer durability would effectively serve in large-scale vision screening programs.

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