Introduction : Colour Blindness

What is colour blindness?

Colour (color) blindness (colour vision deficiency, or CVD) affects approximately 1 in 12 men
(8%) and 1 in 200 women in the world. In Malaysia this means that there are approximately
1.3 million colour blind people (about 4.5% of the entire population 29.7 million), most of
whom are male.

The retina of the eye has two types of light-sensitive cells called rods and cones. Both are
found in the retina which is the layer at the back of your eye which processes images. Rods
work in low light conditions to help night vision, but cones work in daylight and are
responsible for colour discrimination.

There are three types of cone cells and each type has a different sensitivity to light
wavelengths. One type of cone perceives blue light, another perceives green and the third
perceives red. When you look at an object, light enters your eye and stimulates the cone
cells. Your brain then interprets the signals from the cones cells so that you can see the
colour of the object. The red, green and blue cones all work together allowing you to see the
whole spectrum of colours. For example, when the red and blue cones are simulated in a
certain way you will see the colour purple.

Statistics

There is general agreement that worldwide 8% of men and 0.5% of women have a colour
vision deficiency. These figures rise in areas where there is a greater number of white
(Caucasian) people per head of population, so in Scandanavia the figures increase to
approximately 10-11% of men. By contrast in sub-Saharan Africa there are few colour blind
people. Countries such as India and Brazil have a relatively high incidence of colour vision
deficients because of the large numbers of people with mixed race genes in their genetic
history.

The 8% of colour blind men can be divided approximately into 1% deuteranopes, 1%

protanopes, 1% protanomalous and 5% deuteranomalous. Approximately half of colour blind
people will have a mild anomalous deficiency, the other 50% have moderate or severe
anomalous conditions.

Numbers of tritanopes/tritanomalous people and achromats is very small, perhaps 1 in 30-

50,000 people.

Reliable statistics for people with an acquired form of colour vision deficiency are difficult to
find but as many as 3% of the population could be affected because age-related deficiency is
relatively common in the over 65s and therefore on the increase in the UK due to the rising
numbers of elderly people per capita.

To put these statistics in context, an all-boys school in the Home Counties of England with
1000 pupils would have approximately 100 colour deficient students. 12-13 would be
deuteranopes, 12-13 would be protanopes, 12-13 would have a form of protanomaly and 62
would have a form of deuteranomaly. About half of those with an anomalous condition
would have a moderate to severe form of deficiency.

Main Point 1 : Types of Colour Blindness

There are several types of inherited colour blindness.

1)Trichromacy ( 3 cone function)

Normal colour vision uses all three types of light cones correctly and is known as
trichromacy. People with normal colour vision are known as trichromats.

2) Dichromacy ( 2 cone can be used, another 1 fail)

People with dichromatic colour vision have only two types of cones which are able to
perceive colour i.e. they have a total absence of function of one cone type. Lack of ability to
see colour is the easiest way to explain this condition but in actual fact it is a specific section
of the light spectrum which can’t be perceived (dilihat). For convenience we call these areas
of the light spectrum ‘red’, ‘green’ or ‘blue’ . The sections of the light spectrum which the
‘red’ and ‘green’ cones perceive overlap and this is why red and green colour vision
deficiencies are often known as red/green colour blindness and why people with red and
green deficiencies see the world in a similar way.

People suffering from (most common) protanopia are unable to perceive any ‘red’ light
green colour blind, those with deuteranopia are unable to perceive ‘green’ light and those
with tritanopia are unable to perceive ‘blue’ light. And yellow cant see

3) Monochromacy (achromatopsia) (Can’t see color)

People with monochromatic vision can see no colour at all and their world consists of
different shades of grey ranging from black to white, rather like only seeing the world on an
old black and white television set. Achromatopsia is extremely rare, occuring only in
approximately 1 person in 33,000 and its symptoms can make life very difficult. Usually
someone with achromatopsia will need to wear dark glasses inside in normal light
conditions.

Our research has revealed that in many cases opticians have only received basic training on
colour vision deficiency and some may therefore be incorrectly interpreting the results of
the Ishihara tests.
Main Point 2 : Causes of Colour Blindness

1) Colour blindness is a usually a genetic condition (you are born with it). Red/green and
blue colour blindness is usually passed down from your parents. The gene which is
responsible for the condition is carried on the X chromosome and this is the reason why
many more men are affected than women. The vast majority of people with a colour
vision deficiency have inherited their condition from their mother, who is normally a
‘carrier’ but not colour blind herself.

2) Some people also acquire the condition as a result of long-standing diseases such as
diabetes, multiple sclerosis, some liver diseases and almost all eye diseases. How it is
acquired:

Chronic illnesses which can lead to colour blindness include Alzheimer’s disease, diabetes
mellitus, glaucoma, leukaemia, liver disease, chronic alcoholism, macular degeneration,
multiple sclerosis, Parkinson’s disease, sickle cell anaemia and retinitis pigmentosa.

Accidents or strokes that damage the retina or affect particular areas of the brain/eye can
lead to colour blindness.

Medications such as antibiotics, barbiturates, anti-tuberculosis drugs, high blood pressure

medications and several medications to treat nervous disorders may cause colour blindness.

Industrial or environmental chemicals such as carbon monoxide, carbon disulphide and

some containing lead can also cause colour blindness.

Age – in people over 60 years of age physical changes can occur which might affect a
person’s capacity to see colours.

The effects of colour vision deficiency can be mild, moderate or severe depending upon the
defect. If you have inherited colour blindness your condition will stay the same throughout
your life – it won’t get any better or worse.

3) The exact physical causes of colour blindness are still being researched but it is believed
that colour blindness is usually caused by faulty cones but sometimes by a fault in the
pathway from the cone to the brain.

People with normal colour vision have all three types of cone working correctly but colour
blindness occurs when one or more of the cone types are faulty. For example, if the red cone
is faulty you won’t be able to see colours containing red clearly. Most people with colour
blindness can’t distinguish certain shades of red and green.

Main point 3 : Treatment

1)There is currently no treatment for inherited colour blindness. Colour filters or contact
lenses can be used in some situations to enhance the brightness between some colours and
these are occasionally used in the workplace, but many colour blind people find these
actually confuse them further rather than help.

You can also use tinted lenses for both eyes, but the tints must be different colors to
maintain difference in what each eye is seeing

The manufacturers of these lenses generally promise the following improvements:

 Improve general color perception

 Make colors brighter and clearer
 Allow shades of color, previously unseen, to be observed
 Improve the ability to name colors correctly (especially when assistance is provided
in this area e.g. by relatives or friends)

2)There is hope on the horizon for a ‘cure’ for inherited colour vision deficiency using gene
technology . This will involve injecting genetic material into the eye which try to help to
correct 2nd cromosom. At the moment there have been no trials on humans but the process
has been proved to work in monkeys. Once it has been established and treated, your vision
may return to normal.