Predicted effectiveness of EnChroma multi-notch filters for enhancing color perception in anomalous trichromats.

EnChroma filters are aids designed to improve color vision for anomalous trichromats. Their use is controversial because the results of lab-based assessments of their effectiveness have so far largely failed to agree with positive anecdotal reports. However, the effectiveness of EnChroma filters will vary depending on the conditions of viewing, including whether the stimuli are broadband reflective surfaces or colors presented on RGB displays, whether illumination spectra are broadband or narrowband, the transmission spectra of particular filters, and the cone spectral sensitivity functions of the observer. We created a model of anomalous trichromatic color vision to predict the effects of EnChroma filters on the color signals impaired in anomalous trichromacy. Using the model we varied illumination, filter type and observer cone sensitivity functions, and tested the effect of presenting colors as broadband reflective surfaces or on RGB displays. We also used hyperspectral images to assess the impact of the filters on anomalous trichromats' color vision for natural scenes. Model results predicted that the filters should be broadly effective at enhancing anomalous trichromats' equivalent to L/(L + M) chromatic contrasts under a range of viewing conditions, but are substantially more effective for deuteranomals than for protanomals. The filters are predicted to be more effective for broadband reflective surfaces presented under broadband illuminants than for surfaces presented under narrowband illuminants or for colors presented on RGB displays. Since the potential impacts of contrast adaptation and perceptual learning are not considered in the model, it needs to be empirically validated. Results of empirical tests of the effects of EnChroma filters on deuteranomalous color vision in comparison with model predictions are presented in an accompanying paper (Somers et al., in prep.).

Empirical tests of the effectiveness of EnChroma multi-notch filters for enhancing color vision in deuteranomaly.

Manufacturers of notch filter-based aids for color vision claim that their products can enhance color perception for people with anomalous trichromacy, a form of color vision deficiency (CVD). Anecdotal reports imply that people with CVD can have radically enhanced color vision when using the filters. However, existing empirical research largely focussed on the effect of notch filters on performance on diagnostic tests for CVD has not found that they have any substantial effect. Informed by a model of anomalous trichromatic color vision, we selected stimuli predicted to reveal the effects of EnChroma filters. Using these stimuli, we tested the ability of EnChroma filters to enhance color vision for 10 deuteranomalous trichromats in three experiments: 1. asymmetric color matching between test and control filter conditions, 2. color discrimination measured using four alternative forced-choice, and 3. color appearance measured using dissimilarity ratings to reconstruct subjective color spaces using multidimensional scaling. To investigate potential effects of long-term adaptation or perceptual learning, participants completed all three experiments at two time points, on first exposure to the filters, and after a week of regular use. We found a significant effect of the filters on color matches in the direction predicted by the model at both time points, implying that the filters can enhance the anomalous trichromatic color gamut. However, we found minimal effect of the filters on color discrimination at threshold. We found a significant effect of the filters in enhancing the appearance of colors along the red-green axis at the first time point, and a trend in the same direction at the second time point. Our results provide the first quantitative experimental evidence that notch filters can enhance color perception for anomalous trichromats.

Measuring visual acuity and spherical refraction with smartphone screens emitting blue light

Introduction A periodical self-monitoring of spherical refraction using smartphones may potentially allow a quicker intervention by eye care professionals to reduce myopia progression. Unfortunately, at low levels of myopia, the far point (FP) can be located far away from the eye which can make interactions with the device difficult. To partially remedy this issue, a novel method is proposed and tested wherein the longitudinal chromatic aberration (LCA) of blue light is leveraged to optically bring the FP closer to the eye. Methods Firstly, LCA was obtained by measuring spherical refraction subjectively using blue pixels in stimuli shown on organic light-emitting diode (OLED) screens and also grey stimuli with matching luminance. Secondly, the visual acuity (VA) measured with a smartphone located at 1.0 m and 1.5 m and displaying blue optotypes was compared with that obtained clinically standard measurements. Finally, the spherical over refraction obtained in blue light with a smartphone was compared with clinical over-refraction with black and white (B&W) optotypes placed at 6 m. Results Mean LCA of blue OLED smartphone screens was −0.67 ± 0.11 D. No significant differences (p > 0.05) were found between the VA measured with blue optotypes on a smartphone screen and an eye chart. Mean difference between spherical over-refraction measured subjectively by experienced subjects with smartphones and the one obtained clinically was 0.08 ± 0.34 D. Conclusions Smartphones using blue light can be used as a tool to detect changes in visual acuity and spherical refraction and facilitate monitoring of myopia progression. (AU)

Comparison of Two Printed Pseudoisochromatic Tests for Color Vision Assessment.

SIGNIFICANCE: The Waggoner PIP24 is a pseudoisochromatic test with a pattern similar to the Ishihara test. This study determined that the W-PIP24 can be used clinically to yield screening results (or sensitivity and specificity) comparable with the Ishihara. PURPOSE: This study aimed to determine whether the W-PIP24 is equivalent to the Ishihara 38 edition pseudoisochromatic test in detecting red-green color vision defects. Also, the performance of each plate of the W-PIP24 in detecting the color vision defects relative to the Ishihara test was determined. METHODS: Sixty-three individuals with congenital red-green color vision defects and 57 with normal trichromacy were recruited. Participants were tested with both the Ishihara and W-PIP24. The first-order agreement coefficients were calculated for the Ishihara and W-PIP24. The results were also analyzed using specificity, sensitivity, efficiency, and predictive pass and fail values. RESULTS: The agreement between the W-PIP24 and Ishihara test using the recommended criterion of using all plates was perfect. The sensitivity, specificity, predictive pass, and predictive fail were 1.00 (95% confidence interval, 0.94 to 1.00). CONCLUSIONS: This study showed that the W-PIP24 using a failure criterion of three or more errors on screening plates 1 to 15 is equivalent to the Ishihara test while screening for red-green color vision deficiency using a failure criterion of three or more errors on screening plates 1 to 17 of the Ishihara 38 edition.

Effect of laser eye protection devices on color perception.

Laser eye protection (LEP) devices may alter how colors are perceived in visual displays. This study investigates changes in color perception experienced by color-normal observers while wearing LEPs. Color perception with and without LEPs was measured using clinical color tests: City University Color Assessment and Diagnosis, Konan Medical ColorDx CCT-HD, and Farnsworth-Munsell 100-Hue. All LEPs induced a shift in color perception. The level of change in color perception significantly varied across LEPs. Consideration should be made when designing color displays where LEP devices are worn.

Elimination of the color discrimination impairment along the blue-yellow axis in patients with hypothyroidism after treatment with levothyroxine as assessed by the Farnsworth-Munsell 100 hue test.

Our previous study has shown that individuals with untreated hypothyroidism display significantly higher partial error scores (P E S) along the blue-yellow axis compared to the red-green axis than normal individuals using the Farnsworth-Munsell 100 hue test [J. Opt. Soc. Am. A37, A18 (2020)JOAOD60740-323210.1364/JOSAA.382390]. We wished to determine how color discrimination may change when hypothyroidism has been treated to the point of euthyroidism. Color discrimination was reassessed for 17 female individuals who had undergone treatment for hypothyroidism, and the results were compared with 22 female individuals without thyroid dysfunction. No statistically significant difference was found in the total error score (T E S) for the first and second measurements for both groups (p>0.45). The P E S for the hypothyroid group improved significantly in the previously impaired color regions after the treatment. Color discrimination defects found in untreated hypothyroidism can be negated with treatment of the condition over an appropriate time period.

Clinical analysis of the Konan-Waggoner D15 color vision test using the Surface-Pro display.

This work expands on our previous comparison of the Konan-Waggoner D15 (KW-D15) and Farnsworth D15 (F-D15). Sixty subjects with normal color vision and 68 subjects with a red-green color vision defect participated in the study. The KW-D15 had good agreement with the F-D15 for both pass/fail and classification across all failure criteria. The agreement was slightly better if subjects had to pass on 2/3 trials compared with just the first trial. The KW-D15 is an adequate substitute for the F-D15, with the caveat that the KW-D15 might be slightly easier to pass than the F-D15 for deutans.

Evaluation of color vision related quality of life changes due to cataract surgery.

Questionnaires have been used as research tools to provide a standardized approach to assess quality of life at various time periods and populations. However, literature shows only a few articles about self-reported color vision changes. Our aim was to evaluate the subjective patient feelings before and after cataract surgery and compare the results with a color vision test result. Our method was as follows: 80 cataract patients filled out a modified color vision questionnaire and performed the Farnsworth-Munsell 100 Hue Color Vision Test (FM100) before, two weeks, and six months after cataract surgery. We analyzed the correlations between these two types of results, which reveal that FM100 hue performance and subjective perception improved after surgery. Additionally, subjective patient questionnaire scores correlate well with the FM100 test results before and two weeks after the cataract surgery, but this effect decreased with longer follow-up times. We conclude that subjective color vision changes can only be noticed at longer periods after the cataract surgery. Health care professionals can use this questionnaire to better understand the subjective feelings of patients and monitor their color vision sensitivity changes.

Screening for mild anomalous trichromacy using the Ishihara plates test.

The Ishihara plates test is one of the most established and widely used means of identifying color vision deficiencies. However, literature examining the effectiveness of the Ishihara plates test has identified weaknesses, particularly when screening for milder anomalous trichromacy. We constructed a model of the chromatic signals expected to contribute to false negative readings by calculating, for particular anomalous trichromatic observers, the differences in chromaticity between the ground and pseudoisochromatic portions of plates. Predicted signals from five plates were compared for seven editions of the Ishihara plates test, for six observers with three severities of anomalous trichromacy, under eight illuminants. We found significant effects of variation in all of these factors other than edition on the predicted color signals available to read the plates. The impact of edition was tested behaviorally with 35 observers with color vision deficiency and 26 normal trichromats, which corroborated the minimal effect of edition predicted by the model. We found a significant negative relationship between predicted color signals for anomalous trichromats and behavioral false negative plate readings (ρ=-0.46, p=0.005 for deuteranomals, ρ=-0.42, p=0.01 for protanomals), suggesting that residual observer-specific color signals in portions of plates designed to be isochromatic may be contributing to false negative readings, and validating our modeling approach.

Cone contrast test-HD: sensitivity and specificity in red-green dichromacy and the impact of age.

We report normative cone contrast sensitivity values, right-left eye agreement, and sensitivity and specificity values for the cone contrast test-HD (CCT-HD). We included 100 phakic eyes with color vision normal (CVN) and 20 dichromatic eyes (10 with protanopia and 10 with deuteranopia). The CCT-HD was used to measure L, M, and S-CCT-HD scores, and the right and left eyes were evaluated for agreement using Lin's concordance correlation coefficient (CCC) and Bland-Altman analysis to investigate the sensitivity and specificity of the CCT-HD based on diagnosis with an anomaloscope device. All cone types were in moderate agreement with the CCC (L-cone: 0.92, 95% CI, 0.86-0.95; M-cone: 0.91, 95% CI, 0.84-0.94; S-cone: 0.93, 95% CI, 0.88-0.96), whereas the Bland-Altman plots showed that the majority of cases (L-cone: 94%; M-cone: 92%; S-cone: 92%) fell within the 95% limits of agreement and showed good agreement. The m e a n±s t a n d a r d error L, M, and S-CCT-HD scores for protanopia were 0.6±1.4, 74.7±2.7, and 94.6±2.4, respectively; for deuteranopia, these were 84.0±3.4, 40.8±3.3, and 93.0±5.8, respectively; and for age-matched CVN eyes (m e a n±s t a n d a r d deviation age, 53.1±5.8 years; age range, 45-64 years), these were 98.5±3.4, 94.8±3.8, and 92.3±3.4, respectively, with significant differences between the groups except for S-CCT-HD score (Bonferroni corrected α=0.0167, p<0.0167). The sensitivity and specificity of the CCT-HD were 100% for protan and deutan in diagnosing abnormal types in those aged 20 to 64 years; however, the specificity decreased to 65% for protan and 55% for deutan in those aged >65 years. The CCT-HD is comparable to the diagnostic performance of the anomaloscope in the 20-64-year-old age group. However, the results should be interpreted cautiously in those ≥65 years, as these patients are more susceptible to acquired color vision deficiencies due to yellowing of the crystalline lens and other factors.

A diagnostic model based on color vision examination for dysthyroid optic neuropathy using Hardy-Rand-Rittler color plates.

PURPOSE: To investigate color vision deficiency and the value of Hardy-Rand-Rittler (HRR) color plates in monitoring dysthyroid optic neuropathy (DON) to improve the diagnosis of DON. METHODS: The participants were divided into DON and non-DON (mild and moderate-to-severe) groups. All the subjects underwent HRR color examination and comprehensive ophthalmic examinations. The random forest and decision tree models based on the HRR score were constructed by R software. The ROC curve and accuracy of different models in diagnosing DON were calculated and compared. RESULTS: Thirty DON patients (57 eyes) and sixty non-DON patients (120 eyes) were enrolled. The HRR score was lower in DON patients than in non-DON patients (12.1 ± 6.2 versus 18.7 ± 1.8, p < 0.001). The major color deficiency was red-green deficiency in DON using HRR test. The HRR score, CAS, RNFL, and AP100 were found to be important factors in predicting DON from random forest and selected by decision tree to construct the multifactor model. The sensitivity, specificity, and the area under the curve (AUC) of the HRR score were 86%, 72%, and 0.87, respectively. The HRR score decision tree had a sensitivity, specificity, and AUC of 93%, 57%, and 0.75, respectively, with an accuracy of 82%. The data of the multifactor decision tree were 90%, 89%, and 0.93 for sensitivity, specificity, and AUC, respectively, with an accuracy of 91%. CONCLUSION: The HRR test was valid as screening method for DON. The multifactor decision tree based on the HRR test improved the diagnostic efficacy for DON. An HRR score of less than 12 and red-green deficiency may be characteristic of DON.

A Comparison Between Three Computer-Based Cone Specific Color Vision Tests.

INTRODUCTION: Computerized color contrast sensitivity (CS) tests that aim to determine presence, type, and severity of color vision deficiency have been developed and are available, but data on agreement between tests is lacking. The purpose of the present study was to determine data agreement between three computerized color vision tests.METHODS: A total of 50 subjects, 25 color vision normal (CVN) and 25 color vision deficient (CVD), were tested with the Konan CCT-HD®, NCI, and a modified version of the Innova CCT. Sensitivity and specificity were compared across systems as well as differences in log CS values and how these relate to standards used to classify occupational performance.RESULTS: Each test showed 100% sensitivity for detection of hereditary red-green CVDs as well as type (protan vs. deutan). Each test showed 100% specificity for confirming normal red-green color vision in CVNs. Innova CCT and NCI showed 100% specificity in CVNs and CVDs for S cone CS. Konan CCT-HD® showed 96% specificity in CVNs and 92% in CVDs for S cone CS.DISCUSSION: These findings indicate that each test reliably identifies hereditary CVD and confirms normal color vision. However, the three tests differ slightly in log CS values used to determine pass/fail scores of red-green color vision using a 100-point scale, and all show that protans consistently score lower than deutans on cone CS. Hence, depending on the criterion used in occupational settings, a single score may not prove equitable for individuals who have a protan deficiency.Lovell J, Rabin J. A comparison between three computer-based cone specific color vision tests. Aerosp Med Hum Perform. 2023; 94(2):54-58.

Lanthony D15 for Occupational Testing: Short-term Repeatability.

SIGNIFICANCE: The Lanthony D15 has been reported to have poorer repeatability than the Farnsworth D15. This study found that two trials of the test provide high short-term repeatability and can be administered this way for occupational testing. PURPOSE: This study aimed to determine the short-term repeatability of the Lanthony D15 in patients with color vision deficiency. Repeated trials were used to examine if learning effects occur and to determine how many trials would be necessary to ensure the highest short-term repeatability for occupational testing. METHODS: Twenty male subjects (mean [standard deviation] age, 27.2 [4.3] years) with congenital color vision deficiency, ranging from mild to severe, participated in this single-visit study. Visual acuity, color vision book screening, Farnsworth D15, and anomaloscope testing were performed for classification purposes. Ten trials of the Lanthony D15 were performed. Color confusion index scores from each trial were determined, and a repeated-measures analysis of variance was used to compare the scores across trials. Orthogonal polynomial analysis was performed to detect any trends across trials through the third order. The intraclass correlation coefficient was calculated. RESULTS: No differences in color confusion index (mean [standard error of the mean], 3.57 [0.04]) were found across the 10 trials ( P = .18). Legendre polynomials showed no statistical significance (all P > .39). The intraclass correlation coefficient was 0.81 (95% confidence interval, 0.70 to 0.90). Based on the method of Shrout and Fleiss, intraclass correlation coefficients of 0.7, 0.8, and 0.9 could be achieved with an average of one, two, and four trials of the test, respectively. However, empirically, 0.9 was not achievable. CONCLUSIONS: The Lanthony D15 test has fairly high short-term repeatability. Thus, although more trials would likely improve clinical certainty, the mean result of two trials appears sufficient for occupational testing.

Color Vision Testing, Standards, and Visual Performance of the U.S. Military.

INTRODUCTION: Color vision deficiency (CVD) is a disqualifying condition for military special duty occupations. Color vision testing and standards vary slightly among the U.S. military branches. Paper-based pseudoisochromatic plates (PIPs) remain a screening tool. Computer-based color vision tests (CVTs), i.e., the Cone Contrast Test (CCT), the Colour Assessment and Diagnosis (CAD) test, and the Waggoner Computerized Color Vision Test (WCCVT), are now replacing the Farnsworth Lantern Test (FALANT) and its variants to serve as a primary or secondary test in the U.S. Armed Forces. To maintain consistency in recruitment, performance, and safety, the study objectives were to examine military color vision testing, passing criteria, and color discrimination performance. METHODS: Study participants were 191 (17% female) students, faculty, and staff of the U.S. Air Force Academy and the Naval Aerospace Medical Institute. All subjects performed six CVTs, and 141 participants completed two additional military relevant color discrimination tasks. Friedman non-parametric test and Wilcoxon signed-rank post hoc test with Bonferroni adjusted P values were used to compare CVTs and standards. Analysis of variance and Bonferroni adjusted post hoc test were used to describe effects on color discrimination performance. RESULTS: The Heidelberg Multicolor-Moreland and Rayleigh (HMC-MR) anomaloscope diagnosed 58 CVD (30.4%). There were no statistically significant differences in identifying red-green CVD by the HMC-MR, CCT, CAD, WCCVT, and PIP tests (P = .18), or classifying deutan, protan, and normal color vision (CVN) by the HMC-MR and the CVT (P = .25). Classification of tritan CVD was significantly different depending on which CVT was used (P < .001). Second, overall passing rates were 79.1% on the CAD (≤6 standard normal unit (SNU)), 78.5% on the combined PIP/FALANT, 78.0% on the CCT (≥55%), and 75.4% on the WCCVT (mild) military standards. The CVTs and the PIP/FALANT standards were not significantly different in number of personnel selected, but CAD and CCT passed significantly more individuals than WCCVT (P = .011 and P = .004, respectively). The previous U.S. Air Force standard (CCT score ≥75%) passed significantly fewer individuals relative the U.S. Navy pre-2017 PIP/FALANT or the current CVT standards (P ≤ .001). Furthermore, for those who failed the PIP (<12/14), the FALANT (9/9 or ≥16/18) agreed with the CVTs on passing the same CVN (n = 5); however, it also passed moderate-to-severe CVD who did not pass WCCVT (n = 6), CCT (n = 3), and CAD (n = 1). Lastly, moderate/severe CVD were significantly slower and less accurate than the "mild" CVD or CVN in the two color discrimination tasks (P < .001). In comparison to CVN in the in-cockpit display color discrimination task, mild CVD (CCT ≥55% and <75%) were significantly slower by 1,424 ± 290 milliseconds in reaction time (P < .001) while maintaining accuracy. CONCLUSIONS: CVTs are superior to paper-based PIP in diagnosing, classifying, and grading CVD. Relative to the PIP/FALANT standard in personnel selection, the current U.S. military CVT passing criteria offer comparable passing rates but are more accurate in selecting mild CVD. Nevertheless, military commanders should also consider specific operational requirements in selecting mild CVD for duty as reduced job performance may occur in a complex color critical environment.

Aids for color vision deficiency: introduction to the feature issue.

Approximately 8% of Caucasian males and 0.5% of females have congenital red-green color vision deficiencies (CVD), and a number of eye diseases are accompanied by acquired CVD. This feature issue includes ten contributions regarding existing and proposed algorithms and devices intended to help CVD subjects compensate for their color deficiencies. It also addresses limitations in the effectiveness of CVD aids for subjects with different types and degrees of color vision deficiency.

Information gains from commercial spectral filters in anomalous trichromacy.

Red-green color discrimination is compromised in anomalous trichromacy, the most common inherited color vision deficiency. This computational analysis tested whether three commercial optical filters with medium-to-long-wavelength stop bands increased information about colored surfaces. The surfaces were sampled from 50 hyperspectral images of outdoor scenes. At best, potential gains in the effective number of surfaces discriminable solely by color reached 9% in protanomaly and 15% in deuteranomaly, much less than with normal trichromacy. Gains were still less with lower scene illumination and more severe color vision deficiency. Stop-band filters may offer little improvement in objective real-world color discrimination.

Coloured filters can simulate colour deficiency in normal vision but cannot compensate for congenital colour vision deficiency.

Red-green colour vision deficiency (CVD) affects ~ 4% of Caucasians. Notch filters exist to simulate CVD when worn by colour vision normal (CVN) observers (simulation tools), or to improve colour discrimination when worn by CVD observers (compensation tools). The current study assesses effects of simulation (Variantor) and compensation (EnChroma) filters on performance in a variety of tasks. Experiments were conducted on 20 CVN and 16 CVD participants under no-filter and filter conditions (5 CVN used Variantor; 15 CVN and 16 CVD used EnChroma). Participants were tested on Ishihara and Farnsworth-Munsell 100 hue tests, CVA-UMinho colour discrimination and colour naming tasks and a board-game colour-sorting task. Repeated-measures ANOVAs found Variantor filters to significantly worsen CVN performance, mimicking protanopia. Mixed-model and repeated-measures ANOVAs demonstrate that EnChroma filters do not significantly enhance performance in CVD observers. Key EnChroma results were replicated in 8 CVD children (Ishihara test) and a sub-sample of 6 CVD adults (CVA-UMinho colour discrimination and colour naming tasks) for a smaller stimulus size. Pattern similarity exists across hue for discrimination thresholds and naming errors. Variantor filters are effective at mimicking congenital colour vision defects in CVN observers for all tasks, however EnChroma filters do not significantly compensate for CVD in any.

Chromatic discrimination measures in mature observers depend on the response window.

Our past anecdotal evidence prompted that a longer response window (RW) in the Trivector test (Cambridge Colour Test) improved mature observers' estimates of chromatic discrimination. Here, we systematically explored whether RW variation affects chromatic discrimination thresholds measured by the length of Protan, Deutan and Tritan vectors. We employed the Trivector test with three RWs: 3 s, 5 s, and 8 s. Data of 30 healthy normal trichromats were stratified as age groups: 'young' (20-29 years), 'middle-aged' (31-48 years), and 'mature' (57-64 years). We found that for the 'young' and 'middle-aged', the thresholds were comparable at all tested RWs. However, the RW effect was apparent for the 'mature' observers: their Protan and Tritan thresholds decreased at 8-s RW compared to 3-s RW; moreover, their Tritan threshold decreased at 5-s RW compared to 3-s RW. Elevated discrimination thresholds at shorter RWs imply that for accurate performance, older observers require longer stimulus exposure and are indicative of ageing effects manifested by an increase in critical processing duration. Acknowledging low numbers in our 'middle-aged' and 'mature' samples, we consider our study as pilot. Nonetheless, our findings encourage us to advocate a RW extension in the Trivector protocol for testing mature observers, to ensure veridical measures of their chromatic discrimination by disentangling these from other ageing effects-slowing down of both motor responses and visual processing.

Extending the color discrimination metric with consideration of illuminance level.

Color discrimination is a crucial dimension for the visual assessment of white light sources. In this Letter, we took full advantage of data comparability among Farnsworth-Munsell 100 Hue (FM-100) color vision tests and modified our recent proposed color discrimination metric [Opt. Lett.45, 6062 (2020)10.1364/OL.400422] to make it effective in quantifying the color discrimination capability of lighting under multiple illuminance levels. The updated metric was developed based on a meta-analysis of 100 sets of combined visual data derived from three groups of visual studies containing 29 FM-100 trials and its superiority was comprehensively validated by 140 sets of combined data from five groups of studies with 42 FM-100 trials.

A Computer-Based Farnsworth-Munsell 100-Hue (CFM-100) Test in Pilots' Medical Assessments.

OBJECTIVES: This study investigated the effectiveness and identified the cutoff values of the computer-based Farnsworth-Munsell 100-Hue (CFM-100) test for screening color vision deficiencies in the pre-employment examination of civil aviators in China.METHODS: Firstly, subjects were stratified into normal, color weakness, and color blindness with the Ishihara pseudoisochromatic plate test (IPPT) by two ophthalmologists. Then they randomly completed CFM-100 and Farnsworth-Munsell 100-Hue (FM-100) tests. Total error scores (TES) and the time taken for the CFM-100 and FM-100 were analyzed and the cutoff values for the CFM-100 were determined.RESULTS: Of 218 subjects, 159 were normal while 59 were diagnosed with dyschromatopsia. The TES of the CFM-100 were congruent with those of the FM-100 (20.0 ± 18.8 vs. 20.6 ± 17.7, 160.9 ± 66.0 vs. 151.1 ± 66.4). The testing time for the CFM-100, however, was less than the FM-100 (10.3 ± 2.8 min vs. 12.9 ± 2.9 min, 7.8 ± 2.5 min vs. 12.6 ± 3.3 min). The correlation coefficient R was 0.93 and Cohen's kappa was 0.89 for the two methods. Further analyses defined 34 as the cutoff value to differentiate excellent from fair color discrimination (sensitivity 58.0%, specificity 94.7%) and 101 as the cutoff value to judge fair vs. poor (sensitivity and specificity both 98.8%) for the CFM-100. The cut-off value was 72 for distinguishing normal from defective color vision (sensitivity 96.6%, specificity 98.7%) and 110 was for distinguishing color weakness from color blindness (sensitivity 97.6%, specificity 97.7%) for the CFM-100.CONCLUSIONS: The CFM-100 is an effective method for the diagnosis of dyschromatopsia with high sensitivity in screening airline pilots.Zhang Y, Ma J, Cheng S, Hu W. A computer-based Farnsworth-Munsell 100-Hue (CFM-100) test in pilots' medical assessments. Aerosp Med Hum Perform. 2022; 93(4):362-367.