Validationofa

ComputerizedColor
VisionTest
ProgramID#289

EyeDepartment
NavalAerospaceMedicalInstitute
CAPTMatthewRings
CDRDavePicken
Dr.TerraceWaggoner
 DisclosureInformation
85th AnnualScientificMeeting
CAPTMatthewRings,MC,USN
Ihavethefollowingfinancialrelationshipstodisclose:
EmployeeofUnitedStatesNavy

Nofinancialinterest intheproductdescribedherein
Theviewshereinarethesoleopinionofthepresenter
anddonotnecessarilyreflecttheviewsandthe
opinionsoftheUnitedStatesNavy,Federal
Governmentoranyofitsentities.
Iwillnotdiscussofflabeluseinmypresentation
Notaproductadvertisementorendorsement
CurrentColorVisionTestsUSNavy

PseudoisochromaticPlates(PIP)
AnyRed Greencolortest
CurrentlyuseofPIPIshiharaCompatibletest

FarnsworthLantern(FALANT)
DesignedtopassmildCVDin1940s

KnownProblems:
administration,cheating,recording
NavyFutureRequirements
Computerizedtesting
CVDDiagnosisTypeandDegree
Portable
Shipboard&ForwardTheaterdeployable
Easytousewithminimaltraining
RelativeLowCost
SensitiveandSpecific
Printoutofresults,PDFeDocument
FutureofMulticolorCockpitDisplays
CurrentAdvancesinColorTesting
ColourAssessment&Diagnosis(CAD)RGB,age
correction,UKCivilAviationAuthority

ConeContrastTest(CCT)inusebyUSAF,RGB

WaggonerComputerizedColorVisionTest
(WCCVT):optometryschoolsandoffices,online
testingforpolice,hospital,schools.LowCost,easy
toadminister,RGB
WCCVTSoftware(ver1.0)
ScreenerPIPSection(passorfail)

IndividualConeSensitivity(Red,Green&Blue)
typeanddegreeofCVD

ComputerBased(Windows Apple)
ColorimeterCalibrator (Spyder4)
PDFandPrintoutput
LowCost
Purpose

DetermineSensitivity&Specificityof
WaggonerComputerizedColorVisionTest
(WCCVT)

CompareWCCVTtocurrenttests
DetermineSensitivity&Specificity:
PIPplatebook
FALANT
SubjectPopulation
AgeRange1837y.o.
AverageAge23y.o.
Male93%,Female7%
SubjectClass:
NavalAviator 45%
Aircrew 27%
AirTrafficControl 12%
NavalFlightOfficer 7%
MedicalEnlisted 5%
FlightSurgeon 4%
DataCollection
Age,Gender,JobField,VisualAcuity

ColorVisionTests
NagelAnomaloscope
FALANT(Optec900)
9/9correctPass,or16/18correctpass
PseudoisochromaticPlates(PIPICbook)
14testplates,12/14correctpass
WCCVT
FourSections:Screener,Red,Green,andBlue
 WCCVTScoringMethod
PIPScreener:29testplates:Pass2629

Red &Green :32testplateseach

Blue :12testplates
CorrectCorrect
Normal: R G 2832 B 1012
Mild: R G 1527 B 69
Moderate: R G 414 B 35
Severe: R G 03 B 02
 9

236

55
Results:FALANT

FALANTSpecificity100%
For16correctof18presentations

FALANTSensitivity25%
atscoreof16correctof18
ConfidenceInterval:15%37%
Passed80%ofModDeutans
Passed66%ofModProtans
 9and18

FALANTscoresnormalized
(9x5,18x2.5)
Results:PIP

PIPBookSpecificity100%
atscoreof12correctof14plates

PIP BookSensitivity89%
atscoreof12correctof14
ConfidenceInterval:79% 95%
14

10

3
Results:WCCVT

9Protans (Nagel)==9Protans (WCCVT)

55Deutans (Nagel)==55Deutans (WCCVT)

NoTritans identifiedonWCCVT

NomisclassificationsbyWCCVT
(Protanvs.Deutan)
29
26
 ProtanandDeutanSectionScores

Protans
NormalRange

32
Deutans 32
28
28
Results:WCCVT
ScreenerandConeSections
WCCVT100%Specific
236Normal(Nagel)
236Normal(Screenersection)
236Normal(ProtanandDeutansection)

WCCVT100%Sensitive
64CVD(Nagel)
64CVD(Screenersection)
64CVD(ProtanorDeutansection)
WCCVTScreener
Discussion
FALANTpoorscreeningtoolfordetectingCVD
25%Sensitivity
FALANTpassesmajorityofmoderateCVDsubjects

PIPfairscreener(89%sensitivity),
score12correctof14

WCCVT100%Specificand100%Sensitive
ExcellentObjectiveScreeningandDiagnosticTool
AccurateDiagnosisoftypeanddegreeofCVD
AdditionalFindingsand
Discussion
1in4AviationPersonnelwithsomeCVDwho
previouslyscreenednormalonentrance
exam:atNAMIfailedPIPandFALANTwhen
testedproperly
Administrationerrorsvs.memorization?
SimilarratefoundinUSAFstudies

Needforcomputerizedscreeningtoreduce
administrationerrorsofPIPandFALANT.
trainingfundssavings(est ~$2.5Min10
years;@1failurepreventedperwk)
Thanksto:
KonanUSA,CDRWilliamMann,CDRMerrillRice,
LCDRChrisDeAngelis,CAPTKrisBelland
FutureNavyEndeavors
ValidationResearchTabletVersionofWCCVT
NormalizeCCT,CADandWCCVTscores
RewriteAeromedical WaiverGuidetoreflectcurrent
colorvisiontestingadvancementsandSODAPolicy
ContinuetopushtohaveFALANTremovedfromNavy
MANMEDphysicalstandardspolicy
ProposegrandfathercurrentAviatorspassingFALANT
toallowcontinuedflightoncurrentplatforms.
ProposeNavypolicytoincludeuseofvalidated
computertestsforallcolorvisionscreening(Undersea,
Surface,SPECOP)