Purpose. To highlight the importance of using the Farnsworth Panel D-15 Hue test in colour vision testing in patients on ethambutol treatment. Case Report. A 70 year-old lady received ethambutol as part of her anti-tuberculous regime. She developed blue-yellow colour defect detectable with the Farnsworth Panel D-15 Hue test, but not with the Isihara Pseudoisochromatic Plates. Ethambutol was immediately discontinued from her anti-tuberculous regime. Two months later, her colour vision returned to normal. Conclusion. This case report illustrates the importance of regular monitoring of patients receiving ethambutol for blue-yellow colour defect using the Farnsworth Panel D-15 Hue Test.
The majority of patients with dysthyroid eye disease have an acquired colour vision defect. However, no psychophysical investigation of selective damage to colour or flicker pathways has been carried out. In order to clarify the nature of the visual pathology, we have used a psychophysical technique (spectral sensitivity) to selectively stimulate the chromatic and achromatic mechanisms. Spectral spots of size 1 degree presented at a rate of 1 Hz on a bright 1000 td white background are detected by the chromatic mechanism but a rate of 25 Hz reveals the achromatic mechanism. Fifteen patients (28 eyes) between the ages of 50-70 years were tested. The study showed that all patients had reduced spectral sensitivity, either 1 Hz, 25 Hz or both. The patients with reduced 1 Hz or 25 Hz spectral sensitivity only had a shorter systemic and ocular duration of the condition, had no proptosis, normal intraocular pressures in primary gaze, slightly higher intraocular pressures on upgaze, normal visual field plots and FM 100-Hue error scores higher than the normal age-matched values. The patients with reduced both 1 Hz and 25 Hz spectral sensitivities had a longer systemic and ocular duration of the condition, had proptosis, normal intraocular pressures in primary position, higher intraocular pressures on upgaze and higher FM 100-Hue error scores than the age-matched normals and those in Groups 1 and 2. A total of 50% of patients in Group 3 had defective visual field plots. These data suggest that there is a damage of the large achromatic fibres and small chromatic fibres in dysthyroid eye disease. The mechanism of the damage could be one of ischaemic or mechanical or both.
A study was undertaken to determine the effect of polyethylene and polystyrene used in the manufacture of plastic items on colour perception. Colour vision was assessed using the Ishihara plates, panel 015 test and the Farnsworth Munsell 100-Hue test. Two factories were chosen at random. One factory (referred here as factory A) used virgin resin in pellet form (polyethylene) in the manufacturing of plastic containers to store consumer edible oil. The other factory (referred as factory B) used polystyrene to make plastic bags. A total of 39 healthy employees from factory A (mean age 26.4 :t 8.2 years) and 40 healthy employees from factory B (mean age 26.8 :t 9.6 years) were recruited in this study. A control group of 27 normal healthy subjects (mean age 27.4 :t 4.3 years) who were employees of UKM with no occupational involvement with petroleum derivatives were also recruited in this study and they performed the same colour vision tests. All subjects passed the Ishihara plates test showing that none of the subjects (employees of factory A and B, and control subjects) had a congenital red-green defect. All control subjects passed all of the colour vision tests whilst some employees of factories A and B failed the 015 and FM100 Hue tests. For employees from factory A results from the 015 test showed that 7 (17.9%) had a tritan (blue-yellow) type of defect and 1 (2.6%) had a complex type of defect. The FM 100 Hue results of factory A employees showed that 51.3% (n=20) had a complex type of defect. Total error scores (TES) calculated from the FM 100 Hue test revealed that employees from factory A had a statistically significant higher mean TES of 65.13:!: 48.31 compared to that of control subjects with a mean TES of 31.26:!: 14.93. For employees in factory B, 10 employees (25.0%) had a tritan (blue-yellow) type of defect and 2 (5.0%) had a complex type of defect. Results of the FM 100 Hue test showed that 4 employees (1.0%) had a tritan type of defect whereas 22 (55.0%) had a complex type of defect. Mean total error scores (TES) calculated from the FM 100 Hue test revealed that employees from factory B had a statistically significant higher mean TES of 71.54 :t 54.63 compared with that of control subjects with a mean TES of 31.26 :t. 14.93
The above results show that employees of the plastic factories studies are associated with a higher risk of acquiring colour vision defects as compared to normal subjects who are not engaged in the plastic manufacturing industry. This may have an implication towards the future retinal health of employees in petrod1emical-based industries.
BACKGROUND: Occupational exposure to various neurotoxic chemicals has been shown to be associated with colour vision impairment. It seems that this can occur at low exposure levels, sometimes well below the recommended occupational threshold limits. This study was undertaken to determine the effect of exposure to petroleum derivatives (polyethylene, polystyrene) and solvents (perchloroethylene) on colour perception.
METHODS: Colour vision was assessed using the Ishihara plates, the D-15 test and the Farnsworth Munsell 100 Hue test. Two factories using petroleum derivatives and three dry cleaning premises were chosen at random. A total of 93 apparently healthy employees were recruited from the five workplaces. Two age-matched control groups comprising 56 people, who were support staff of the university with no exposure to petroleum, solvents or their derivatives, were also recruited.
RESULTS: All subjects passed the Ishihara test, showing that none had a congenital red-green defect. Some of the exposed employees failed the D-15 and had abnormally high FM100 Hue scores. All control subjects passed all the colour vision tests. The D-15 test showed that 28 per cent (26 of 93) of exposed employees had a colour vision defect whereas the FM 100 Hue test found that 63 per cent (59 of 93) had a colour vision defect. Most defects were of the blue-yellow type (22.6 per cent) when using the D-15 test. However, with the FM 100 Hue test, most defects were of the non-polar type with no specific axis (50.5 per cent). Mean total error scores calculated from the FM100 Hue test for exposed employees were statistically significantly higher than those of the control subjects.
CONCLUSION: Employees directly exposed to petroleum derivatives and solvents have a higher risk of acquiring colour vision defects compared to subjects who are not.
Study sites: Factories; the control subjects were tested at the Optometry Clinic in Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.