Aim: To assess the difficulties encountered by students with congenital color vision defects in daily living and school activities.Methods: A cross‑sectional descriptive study conducted among students of public secondary schools in Ibadan, Nigeria. Structured questionnaires were administered to all consenting students to determine difficulties encountered in aspects of color matching and color recognition.Results: A total of 1635 students (male:female 1:1.1) were screened of whom 37 (2.3%) had congenital color vision defect. A statistically significant proportion (P &lt; 0.0001) of them reported difficulties with color‑related school work and day‑to‑day activities.Conclusion: Congenital color vision deficient students encounter some difficulty with school work and daily living activities, hence a need to identify them early and give appropriate career guidance.Keywords: Color vision, color vision defect, congenita

Fasina, Oluyemi

Ogun, Olufunmilola A.

Ugalahi, Mary Ogbenyi

English

AJOL - African Journals Online

© 2016 Nigerian Journal of  Ophthalmology | Published by Wolters Kluwer ‑ Medknow20deficient encounter some difficulties in learning. On the other hand, some authors[12,13] reported that color deficient individuals performed well in occupations in which normal color vision was a requirement by developing mechanisms to cope with these activities. However, the evidence from these studies were considered inadequate and inconclusive.[14-16] The Health and Safety Executive[17] in the United Kingdom advises color vision test for employees in occupations where color vision is necessary for safety or quality assurance. Measures like these are, however, not in place in Nigeria, and to the best of the authors’ knowledge, there are no studies reporting the effect of color vision defect on color‑related tasks in the country. Hence, this study sets out to determine the difficulties encountered by secondary school students with congenital color vision defect in school and daily activities.INTRODUCTIONThere is an increasing use of colors in activities of daily living and individuals with color vision defects encounter difficulties performing certain color-related tasks[1-3] such as in the choice of clothing, differentiating colors in the work environment,[1-4] and may also be at risk of road traffic accidents.[5-7]Color vision defect can be a handicap in some occupational specialties in medicine such as laboratory science and histopathology; thus, necessitating screening among medical students, medical laboratory workers, and those aspiring to study medicine in some countries.[8-10] A study[11] conducted among medical students showed that students who are color Impact of Congenital Color Vision Defect on Color‑related Tasks Among Secondary School Students in Ibadan, Southwest NigeriaMary Ogbenyi Ugalahi, Oluyemi Fasina1, Olufunmilola A. Ogun1Department of Ophthalmology, University College Hospital, 1Department of Ophthalmology, College of Medicine, University College Hospital, Ibadan, Oyo State, NigeriaABSTRACTAim:	To	assess	the	difficulties	encountered	by	students	with	congenital	color	vision	defects	in	daily	living	and	school	activities.	Methods: A cross-sectional descriptive study conducted among students of public secondary schools in Ibadan, Nigeria. Structured	 questionnaires	 were	 administered	 to	 all	 consenting	 students	 to	 determine	 difficulties	 encountered	 in	 aspects	of color matching and color recognition. Results: A total of 1635 students (male:female 1:1.1) were screened of whom 37	(2.3%)	had	congenital	color	vision	defect.	A	statistically	significant	proportion	(P	<	0.0001)	of	them	reported	difficulties	with	color-related school work and day-to-day activities. Conclusion:	Congenital	color	vision	deficient	students	encounter	some	difficulty	with	school	work	and	daily	living	activities,	hence	a	need	to	identify	them	early	and	give	appropriate	career	guidance.Keywords: Color vision, color vision defect, congenitalAddress for correspondence  Dr. Mary Ogbenyi Ugalahi, Department of Ophthalmology, University College Hospital, Ibadan, Oyo State, Nigeria. E-mail: oheobe26@yahoo.comAccess this article onlineQuick Response CodeWebsite:www.nigerianjournalofophthalmology.comDOI:***ORiginAl ARticleHow to cite this article: ***This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms.For reprints contact: reprints@medknow.comUgalahi, et al.: Congenital color vision defects and color‑related tasksNigerian Journal of  Ophthalmology / Jan‑Jun 2016 / Vol 24 / Issue 1 21College Hospital, Ibadan, while permission was also obtained from relevant schools’ authorities. Written informed consent was obtained from the parent/guardian of each student and verbal assent from each student.The data collected were analyzed with the Statistical Package for Social Sciences (SPSS) software version 16 (SPSS for Windows, version 16; SPSS, Inc., Chicago, Illinois, the USA). Means were calculated for quantitative continuous variables while frequencies and proportion were used to summarize qualitative variables. Associations between qualitative variables were determined using Chi‑square with level of significance set at 0.05.RESULTSA total of 1635 students were interviewed, comprising 769 (47.0%) males with a mean age of 13.9 ± 1.9 years. Thirty-seven (2.3%) students had congenital color vision defect while 1598 (97.7%) had normal color vision.Fifteen (0.9%) of the 1635 students had difficulty working on the computer while 7 (0.5%) had difficulty identifying different teams during inter-house sports based on colors of jerseys [Table 1]. In activities of daily living, 13 (0.8%) students had difficulty selecting colors of clothes while 5 (0.3%) had difficulty recognizing traffic signals [Table 2].On cross tabulation of congenital color deficient respondents with normal respondents, a statistically significant proportion of color deficient students had difficulties with color-related school work (P < 0.001) [Table 3] and activities of daily living (P < 0.001) [Table 4].DISCUSSIONVarious degrees of difficulties with color-related school work were found among both color deficient and noncolor deficient students in our study. However, a statistically significant proportion of students with color vision defects reported more difficulties as compared to those with normal color METHODSThis is a descriptive cross‑sectional study carried out among secondary school students in Ibadan, Southwest Nigeria.A multistage sampling technique was used to randomize students from three public co‑educational schools out of the 27 registered schools in Ibadan North Local Government into the study. Sample size was calculated using the Leslie Kish formula[18] for single proportions where prevalence was set at 8%[19] at a confidence interval of 95% and a 0.5% precision.Three secondary schools were selected by simple random sampling. All eligible students in the junior and senior arms of the three randomized schools were recruited into this study. Exclusion criteria included presenting visual acuity of 6/60 or worse in either eye, as severe visual impairment may affect color vision assessment,[20] uniocular visual impairment, or color vision deficiency in one eye which is not typical of congenital color deficiency.Visual acuity assessment with a 6 m Snellen’s chart in a well‑illuminated outdoor environment was performed for all the students. Color vision assessment was done with an Ishihara chart (2011 edition) in a well-illuminated room after a detailed ocular examination. Congenital color vision deficiency was diagnosed as inability to read three plates or more of the Ishihara chart in both eyes.[21] Interviewer-administered questionnaires were administered to all the students participating in the study to find out difficulties faced in color-related school tasks and activities of daily living. The questionnaire used in the study by Steward and Cole[22] was modified to reflect the common activities performed by students in this locality. The questionnaire was further validated by a pilot study among secondary school children in a school not randomized into this study. Questions on color identification and matching both at school and away from school were asked. In addition, frequency of difficulty with these activities was assessed.Ethical approval was obtained from the Institutional Review Board of University of Ibadan/University Table 1: Difficulties with color‑related school tasks reported by studentsVariables Never (%)Occasionally (%)Frequently (%)All the time (%)No response (%)Total (%)Colors and picture chart in mathematics text 1625 (99.4) 4 (0.2) 4 (0.2) 1 (0.1) 1 (0.1) 1635 (100)Working on the computer 1616 (98.9) 8 (0.5) 5 (0.3) 2 (0.1) 4 (0.2) 1635 (100)Colors in fine arts 1623 (99.2) 6 (0.4) 4 (0.2) 1 (0.1) 1 (0.1) 1635 (100)Colors in crafts and hobbies 1623 (99.2) 6 (0.4) 3 (0.2) 1 (0.1) 2 (0.1) 1635 (100)Identifying houses or teams during inter‑house sports based on color of jersey1626 (99.4) 3 (0.2) 3 (0.2) 1 (0.1) 2 (0.1) 1635 (100)Ugalahi, et al.: Congenital color vision defects and color‑related tasksNigerian Journal of  Ophthalmology / Jan‑Jun 2016 / Vol 24 / Issue 122vision (P < 0.0001) suggesting that students with color vision defects have more difficulties performing color-related tasks. Many studies[2-4,8,9] have shown that color vision deficiency can be a handicap in color-related tasks, and these may affect the time taken to complete such tasks. Lampe et al.[23] in an earlier study among school children, however, reported that color vision deficiency was not found to affect academic performance or intelligent quotient although different parameters were assessed in their study. They used the “Stanford Achievement Test” assessing word meaning, paragraph meaning, word Table 2: Difficulties with activities of daily living reported by studentsVariables Never (%)Occasionally (%)Frequently (%)All the time (%)No response (%)Total (%)Selecting colors of clothes 1621 (99.1) 10 (0.6) 3 (0.2) ‑ 1 (0.1) 1635 (100)Identifying flowers based on colors 1627 (99.5) 2 (0.1) 3 (0.2) 2 (0.1) 1 (0.1) 1635 (100)Judging ripeness of fruits and vegetables based on colors 1624 (99.3) 2 (0.1) 5 (0.3) 3 (0.2) 1 (0.1) 1635 (100)Watching sports because of color of team jersey 1628 (99.6) 2 (0.1) 2 (0.1) 1 (0.1) 2 (0.1) 1635 (100)Recognizing and describing cars based on colors 1626 (99.4) 6 (0.4) 1 (0.1) 1 (0.1) 1 (0.1) 1635 (100)Recognizing traffic signal lights 1624 (99.3) 2 (0.1) 2 (0.1) 1 (0.1) 6 (0.4) 1635 (100)Table 3: Effect of color vision on performance with school activitiesPerformance in color‑related school activities Color deficient (%) Fisher’s exact testPYes No TotalIdentifying colors and charts in mathematicsSome difficulty 6 (66.6) 3 (33.3) 9 (100) 169.714 <0.0001No difficulty 31 (1.9) 1595 (98.1) 1626 (100)Working on the computerSome difficulty 9 (60.0) 6 (40.0) 15 (100) 228.170 <0.0001No difficulty 28 (1.7) 1592 (98.3) 1620 (100)Colors in fine artsSome difficulty 8 (72.2) 3 (27.3) 11 (100) 248.610 <0.0001No difficulty 29 (1.8) 1595 (98.2) 1624 (100)Identifying colors in crafts and hobbiesSome difficulty 6 (60) 4 (40) 10 (100) 151.646 <0.0001No difficulty 31 (1.9) 1594 (98.1) 1625 (100)Identifying different houses or teams during inter‑house sports based on color of jerseySome difficulty 6 (85.7) 1 (14.3) 7 (100) 221.353 <0.0001No difficulty 31 (1.9) 1597 (98.1) 1628 (100)Table 4: Effect of color vision on activities of daily livingActivities of daily living Color deficient (%) Fisher’s exact testPYes No TotalSelecting colors of clothesSome difficulty 7 (53.8) 6 (46.2) 13 (100) 157.646 <0.0001No difficulty 30 (1.8) 1592 (98.2) 1622 (100)Identifying flowers based on colorsSome difficulty 6 (85.7) 1 (14.3) 7 (100) 221.353 <0.0001No difficulty 31 (1.9) 1597 (98.1) 1628 (100)Judging ripeness of fruits and vegetablesSome difficulty 8 (80.0) 2 (20.0) 10 (100) 274.901 <0.0001No difficulty 29 (1.8) 1597 (98.0) 1628 (100)Watching sports because of colorsSome difficulty 4 (80.0) 1 (20.0) 5 (100) 137.029 <0.0001No difficulty 33 (2.0) 1597 (98.0) 1629 (100)Describing and recognizing cars based on colorsSome difficulty 6 (75.0) 2 (25.0) 8 (100) 192.304 <0.0001No difficulty 31 (1.9) 1596 (98.1) 1627 (100)Recognizing traffic signal lightSome difficulty 4 (80.0) 1 (20.0) 5 (100) 137.029 <0.0001No difficulty 33 (2.0) 1597 (98.0) 1630 (100)Ugalahi, et al.: Congenital color vision defects and color‑related tasksNigerian Journal of  Ophthalmology / Jan‑Jun 2016 / Vol 24 / Issue 1 23study skill, spelling, social studies, and arithmetic correlation but not color-related tasks.A statistically significant proportion (P < 0.0001) of color deficient students had difficulty with crafts and hobbies; good color identification is required for the performance of these activities. A study[24] conducted among medical practitioners also showed that color deficient individual had difficulty with clinical signs and laboratory work requiring color identification.In the area of sports, some students reported having difficulty with recognizing colors of jerseys during inter-house sporting competitions. Of these, a statistically significant proportion (P < 0.0001) was color deficient. This is similar to findings by Tiagarelli et al.[4] in a comparative study among subjects with normal color vision and defective color vision. Other studies[25,26] among professional cricketers have shown similar difficulties. In activities of daily living, a significant number of students with color vision defects reported difficulties with these activities compared to students with normal color vision (P < 0.0001), similar to findings in other studies.[2,22] Tiagarelli et al.[4] studied 151 individuals with color deficiency and 302 with normal color vision and found that the color deficient subjects had significant difficulty with selecting colors of clothes, identifying colors in sports, workplace, hobbies, and road signals. Steward and Cole[22] studied individuals with color vision defect and the difficulties encountered with color task. They found a large proportion of the respondents reporting difficulties with color-related activities in daily living and occupation.A prevalence of congenital color vision deficiency of 2.3% was found in this study similar to other studies[27,28] in our environment. Racial variation in the prevalence of congenital color vision is well‑documented with lower prevalence reported in Africans.[29,30] Findings from this study suggest that though there are few people living with this deficiency in our environment, the impact on the life of those affected is significant and further research on this in our environment is suggested.The parameters used in assessing the difficulties experienced by the students in various color‑related tasks may not be applicable to some; however, effort was made to assess the general color‑related activities commonly carried out by all students in the study locality.CONCLUSIONStudents with color vision defects have some difficulties with color-related task at school and daily living. Thus, incorporation of color vision screening in school eye health may ensure early detection of students with color vision defect in view to offering them appropriate vocation/career guidance.AcknowledgmentWe are grateful to all students and teachers of the schools which participated in the study, Dr. Alagi Mathias, who assisted with the statistical analysis and the research team for their hard work.Financial support and sponsorshipNil.Conflicts of interestThere are no conflicts of interest.REFERENCES1. Cole BL, Maddocks JD, Sharpe K. Visual search and the conspicuity of coloured targets for colour vision normal and colour vision deficient observers. Clin Exp Optom 2004;87:294‑304.2. Cole BL, Lian KY. Search for coloured objects in natural surroundings by people with abnormal colour vision. Clin Exp Optom 2006;89:144‑9.3. Ramaswamy S, Hovis JK. Do color‑deficient observers take longer to complete a color‑related task? Optom Vis Sci 2009;86:964‑70.4. Tagarelli A, Piro A, Tagarelli G, Lantieri PB, Risso D, Olivieri RL. Colour blindness in everyday life and car driving. Acta Ophthalmol Scand 2004;82:436‑42.5. Cole BL. Protan colour vision deficiency and road accidents. Clin Exp Optom 2002;85:246‑53.6. Atchison DA, Pedersen CA, Dain SJ, Wood JM. Traffic signal color recognition is a problem for both protan and deutan color‑vision deficients. Hum Factors 2003;45:495‑503.7. Whillans MG. Colour‑blind drivers’ perception of traffic signals. Can Med Assoc J 1983;128:1187‑9.8. Spalding JA. Colour vision deficiency in the medical profession. Br J Gen Pract 1999;49:469‑75.9. Dargahi H, Einollahi N, Dashti N. Color blindness defect and medical laboratory technologists: Unnoticed problems and the care for screening. Acta Med Iran 2010;48:172‑7.10. Spalding JA. Medical students and congenital colour vision deficiency: Unnoticed problems and the case for screening. Occup Med (Lond) 1999;49:247‑52.11. Campbell JL, Spalding JA, Mir FA. The description of physical signs of illness in photographs by physicians with abnormal colour vision. Clin Exp Optom 2004;87:334‑8.12. Cumberland P, Rahi JS, Peckham CS. Impact of congenital colour vision defects on occupation. Arch Dis Child 2005;90:906‑8.13. Cumberland P, Rahi JS, Peckham CS. Impact of congenital colour vision deficiency on education and unintentional injuries: Findings from the 1958 British birth cohort. BMJ 2004;329:1074‑5.14. Cole BL. Impact of congenital colour vision deficiency: Congenital colour vision deficiency does cause problems. BMJ 2005;330:96.15. Wiegersma PA. Impact of congenital colour vision deficiency: Screening could help choice of medical career. BMJ 2005;330:96.16. Sellars RG. Impact of congenital colour vision deficiency: Poor colour vision does not have to be a hindrance. BMJ 2005;330:96.17. Health and Safety Guidance Note MS7, 3rd ed. Color Vision Examination, a Guide for Occupational Health Providers. Available from: http://www.hse.gov.uk/pubns/ms7.htm. [Last accessed on 2015 Nov 06].Ugalahi, et al.: Congenital color vision defects and color‑related tasksNigerian Journal of  Ophthalmology / Jan‑Jun 2016 / Vol 24 / Issue 12418. Kirkwood BR, Sterne JA. Essentials of Medical Statistics. 2nd ed. Massachusetts: Blackwell Science Limited; 2003. p. 420.19. Rogosic V, Bojic L, Karaman K, Lakos‑Krzelj V, Mendes D, Ivanisevic M. Frequency of congenital dyschromatopsias in male population of the Split‑Dalmatian County in Croatia. Arh Hig Rada Toksikol 2003;54:1‑4.20. McCulley TJ, Golnik KC, Lam BL, Feuer WJ. The effect of decreased visual acuity on clinical color vision testing. Am J Ophthalmol 2006;141:194‑6.21. Ishihara’s Tests Manual for Colour Deficiency 38 Plate Edition; 2011.22. Steward JM, Cole BL. What do color vision defectives say about everyday tasks? Optom Vis Sci 1989;66:288‑95.23. Lampe JM, Doster ME, Beal BB. Summary of a three‑year study of academic and school achievement between color‑deficient and normal primary age pupils: Phase two. J Sch Health 1973;43:309‑11.24. Campbell JL, Griffin L, Spalding JA, Mir FA The effect of abnormal colour vision on the ability to identify and outline coloured clinical signs and to count stained bacilli in sputum. Clin Exp Optom 2005;88:376‑81.25. Harris RW, Cole BL. Five cricketers with abnormal colour vision. Clin Exp Optom 2005;88:176‑80.26. Harris RW, Cole BL. Abnormal colour vision is a handicap to playing cricket but not an insurmountable one. Clin Exp Optom 2007;90:451‑6.27. Tabansi PN, Anochie IC, Nkanginieme KE, Pedro‑Egbe CN. Screening for congenital color vision deficiency in primary children in Port Harcourt City; teachers’ knowledge and performance. Niger J Med 2008;17:428‑32.28. Abah ER, Oladigbolu KK, Samaila E, Gani‑Ikilama A. Ocular disorders in children in Zaria children’s school. Niger J Clin Pract 2011;14:473‑6.29. Post RH. Population differences in red and green color vision deficiency: A review, and a query on selection relaxation. Eugen Q 1962;9:131‑46.30. Pickford RW. Natural selection and colour blindness. Eugen Rev 1963;55:97‑101.

Impact of congenital color vision defect on color‑related tasks among Secondary School Students in Ibadan, Southwest Nigeria

https://www.ajol.info/index.php/njo/article/download/147252/136758

Impact of congenital color vision defect on color‑related tasks among Secondary School Students in Ibadan, Southwest Nigeria

Abstract

Similar works

Full text

Available Versions

AJOL - African Journals Online