Children's Book Could Help Catch Color Vision Deficiency

Laird Harrison

May 25, 2021

A new children's book will help identify children with color vision deficiency, its creators hope.

The Curious Eye could be used informally in schools and doctors' offices to help address the gap in screening for a disability sometimes not detected until adulthood, said Rick Whitehead, MD, a pediatric ophthalmologist at Northwest Pediatric Ophthalmology, in Spokane, Washington, who consulted on the project.

The 24-page book asks readers to spot animals and other objects, some of which are concealed in patterns that can't be seen by people with color vision deficiency. By checking their responses using the answer key, they or adults with them can determine whether they're able to distinguish the typical range of colors.

"It looks like a fun book to read," Whitehead told Medscape Medical News. "It's easy for the ideal age group of 3- to 8-year-olds to pick up and then read through."

Color vision deficiency, colloquially known as color blindness, affects 8% of male persons of European heritage. Its prevalence is lower in other ethnic groups and is much lower in female persons. Neither schools nor healthcare professionals in the United States typically screen children for color vision deficiency, Whitehead said. "It's underdiagnosed, and that's probably because it's so common," he said.

Screening requires resources, and because there's no effective treatment for color vision deficiency, public health decision makers have prioritized more serious and treatable conditions, he said.

As a result, many children with color vision deficiency don't know about their condition. This can lead to serious problems. Students may be unable to complete assignments. "Especially this last year, when everyone's on screens, I had kids that were, like, 'I'm trying to do this Zoom class. I can't see the graph because it's red and green. I don't know which one they're talking about,' " said Whitehead.

Teachers may interpret a decision to color a leaf red or a strawberry green as troublemaking.

Adults may invest in training for careers such as aviation, geology, or some medical specialties before discovering they have a disability that disqualifies or limits them.

Whitehead experienced this problem in his own family. "I have a brother who's a physician, and he tells me he struggled with [diagnosing] rashes, because of the red on the skin. He can't tell the lacy appearance vs the other types."

Such anecdotes led to the creation of the book. After hearing such stories in their social circles and on social media, Mike Bonilla, Kristine Brown, and Kate Maldjian, who work at Klick Health, a healthcare marketing company, wrote the book.

They hired Ruby Wang and Flight School Studio to illustrate it on the basis of the standardized Ishihara test for color vision deficiency and consulted with Whitehead and Gavin J. Roberts, MD, a clinical assistant professor of ophthalmology at the Indiana University School of Medicine, in Indianapolis, Indiana.

The book may also be useful for optometrists and might overcome problems with the formal Ishihara test, said Luis Gómez Robledo, MD, a professor of optics at the University of Grenada, in Grenada, Spain. "The main problem for early diagnosis is that the current color blindness tests can be difficult for kids," he told Medscape Medical News in an email. "If the kid has no sense of order, arrangement tests are impossible to do."

Alternative tests, such as those using an anomaloscope or color assessment and diagnosis, may demand more attention and cooperation than some children can muster, he said. Any form of gamification can help. "This format of test can be in any classroom, and it is easier for the teachers to use it," he said.

The Children's Eye Foundation of the American Association for Pediatric Ophthalmology and Strabismus has published a free digital version of the book and some hardcover copies for its members. Klick Health is looking for a commercial publisher.

Whitehead nor Robles have disclosed no relevant financial relationships.

Laird Harrison writes about science, health and culture. His work has appeared in magazines, newspapers , and online publications. He is at work on a novel about alternate realities in physics. Harrison has taught writing at San Francisco State University, UC Berkeley Extension and the Writers Grotto. Visit him at or follow him on Twitter: @LairdH.

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