L University of California, San Francisco - Department of Laboratory Medicine San Francisco General Hospital 1001 Potrero Avenue, San Francisco, CA 94110 Clinical Laboratory-Valerie L. Ng, Ph.D., M.D., Director Clinical Laboratory: Point of Care Testing Date Prepared: December 2002 Prepared by: Ursula Perotti, RN POCT Coordinator Approved by: - Valerie L. Ng, PhD, Director, Clinical L; ISHIHARA’S TESTS FOR COLOR DEFICIENCY PRINCIPLE: mn deficiency”) automatically excludes personnel from ng endpoint color discrimination (e.g., dipstick Color blindness (“color vi performing laboratory tests requi urinalysis). This series of plates is designed to provide a test which gives a quick and accurate assessment of color vision deficiency of congenital origin, ‘This is the most common form of color vision disturbance. Most cases of congenital color vision deficiency are characterized by a red-green deficiency which may be of two types; first, a protan type which may be complete (protanopia) or partial (protanomalia), and secondly, a deutan type which may be complete (deuteranopia) or partial (deuteranomalia), Consequently, one of the peculiarities of red-green deficiency is that blue and yellow colors appear to be remarkably clear compared with red and green colors. The application of this peculiarity to the test for color vision deficiencies is the distinguishing feature of this series. ‘Among the congenital color vision deficiencies, total color weakness is very rare. Page 1 of 5 FADOCWPOCTIPOC Procedures\Color test v2.doe 12/20/2002Color test v2 POC Testing, I. m1. Vv. Vi. vil. December 2002 In total color weakness, the color sensitivity to red and green, as well as to yellow and blue is very low, and only the clear colors can be perceived; but, aside from the color sensitivity, there is no abnormality in the visual functions. The plates in this book form an easy method of establishing this diagnosis in such cases, and in distinguishing them from cases of red-green deficiencies. ‘There is a very rare group of persons who suffer from total color blindness and show a complete failure to discriminate any color variations, usually with an associated impairment of central vision, with photophobia and nystagmus. Finally, a failure in the appreciation of blue and yellow may be termed tritanomalia if partial and tritanopia is complete; this, too is a very rare condition. The plates in this book are not designed for the diagnosis of such cases. SPECIMEN: N/A INSTRUMENTATION: N/A REAGENTS: A. Stock Reagents: N/A B. Working Reagents: N/A CALIBRATION: A. Standards: N/A B, Special Instructions: N/A QUALITY CONTROL: N/A PROCEDURE: A. Testing should be conducted in a room well-lit by natural daylight. 1. The introduction of direct sunlight or the use of electric light may produce some color discrepancy in the results because of an alteration in the appearance of shades of color. 2. When only electric light is available, it should be adjusted as far as possible to approximate natural daylight. B. _Theplates are held 29.5 inches (75 em) from the subject and tilted so that the plane of the paper is at right angles to the line of vision. C. The numbers which are seen on plates are stated, and each answer should be given without more than three seconds delay. Page 2 of 5 FADOC\POCTIPOC Procedures\Color test v2.doe 12/20/2002Color test v2 POC Testing December 2002 2 8 3 x 3 5 2 x 4 29 70 x 5 74 2 x 6 7 x x 7 45 x x 8 2 = x 9 x 2 x 10 16 x x ‘Traceable x bs X = failure to recognize a number or trace a shape (plate 11). G. Analysis of the results 1. Amassessment of the readings of plates 1 to 11 determines the normality or defectiveness of color vision. If 10 or more plates are read normally, the color vision is regarded as normal. 2. Only individuals who correctly read 10 or more plates can perform laboratory tests with color endpoint determinations. Page 3 0f5 FADOCPOCTPOC Procedures\Color test y2.doe 12/20/2002,Color test v2 POC Testing December 2002 3. Plates 12, 13 and 14 are not reviewed. This test is designed merely to separate those with color vision deficiencies from those with normal color appreciation. VIII. CALCULATIONS: N/A IX. REPORTING RESULTS: A. Record results on Test Result Form (see attached). B. Provide copy of Test Result Form to POCT Coordinator. PROCEDURE NOTES: A. Special Precautions: N/A B. Possible Sources of Error: It is important that the book of plates be kept closed, except during use, because excessive exposure to sunlight will cause fading of the color plates. XI. LIMITATIONS OF METHOD: N/A XII. REFERENCES: 1. Ishihara’s Tests for Colour Deficiency, Concise Edition, 2001. Kanehara Trading Inc. Tokyo, Japan. XII. DISTRIBUTION: 1, Point of Care Test Sites 2. Point of Care Master Procedure Book (2M 14) Page 4 of 5 FADOCWPOCTIPOC Procedures\Color test v2.doe 12/20/2002Color test v2 POC Testing December 2002 San Francisco General Hospital Medical Center ‘Test Result Form for Color Deficiency Employee Name: License #: Tester: Dat Person with Person with Number of plate Answer Normal Person red-green total _ deficiencies | _colorblindess 1 2 2 12 2 8 3 x 3 5 2 x 4 29 70 x 5 7 21 x 6 7 x x 7. 45 x x 8 2 x x 9 x 2 x — 10 16 x x i ‘traceable x x X= failure to recognize a number or trace a shape (plate 11) Comments: Page 5 of 5 FADOC\POCTWOC Procedures\Color test v2.doe 12/20/2002,