Association Between Color Vision Deficiency and Myopia in Chinese Children Over a Five-Year Period

Abstract

Purpose To explore the relationship of color vision deficiency with myopia progression and axial elongation in Chinese primary school children during a five-year cohort study. Methods A total of 2849 grade 1 students (aged 7.1 ± 0.4 years) from 11 primary schools were enrolled and followed up for five years. Cycloplegic autorefraction and axial length were measured annually. Color vision testing was performed using Ishihara's test and the City University color vision test. Results The prevalence of color vision deficiency was 1.68%, with 2.81% in boys and 0.16% in girls. Color-deficient cases consisted of 91.6% deutan and 8.3% protan. Over the five years, the cumulative incidence of myopia was 35.4% (17/48) in the color-vision deficiency group, which was lower than the 56.7% (1017/1794) in the color normal group ( P = 0.004). Over the five-year study period, the change in spherical equivalent refraction in the color vision–deficiency group (−1.81 D) was also significantly lower than that in the color normal group (−2.41 D) ( P = 0.002). Conclusions The lower incidence and slower progression of myopia in children with color-vision deficiency over the five-year follow-up period suggest that color-deficient individuals are less susceptible to myopia onset and development.

Factors associated with myopia in 19-year-old adult men in Korea between 2014 and 2020

“…Studies have shown that the rate of myopia is low in the case of color weakness and color blindness 9 , 17 – 19 . The results are consistent with those of a previous study, which reported lower myopia development in individuals with color weakness and color blindness 18 . Another study reported that the risk of myopia is high in individuals with diabetes 20 .…”

Color vision deficiency is associated with increased prevalence of amblyopia, strabismus and ametropia: A large population study

“…11 Gan et al have also shown a lower incidence of myopia and myopia progression in Chinese primary school children with CVD. 13 On the other hand, Rajavi et al found a higher incidence of refractive errors among primary school CVD Iranian children, 27 and Machluf et al showed that individuals with either myopia or hyperopia had higher incidence of CVD, compared with emmetropes. 14 Our study, reporting on over 37,000 individuals with CVD, supports the latter studies, nding that CVD is associated with increased prevalence of both moderate and severe ametropia.…”

“…Some researchers found a lower incidence of ametropia and myopia progression in individuals with CVD, whereas others have reported the opposite. [11][12][13][14] The aim of this study is to assess whether CVD is associated with other ophthalmic conditions that may affect vision in other ways besides color identi cation, in a large population study involving young males undergoing medical evaluation for military service.…”

Sex Disparity in Myopia Explained by Puberty Among Chinese Adolescents From 1995 to 2014: A Nationwide Cross-Sectional Study

“…Recent studies indicate that the L:M cone ratio, combined with L and/or M opsin exon 3 haplotypes at chromosome location Xq28, cause minor splicing defects that could increase myopia susceptibility. Because girls have two X-chromosomes, they are two times as likely to carry a cone opsin polymorphism, potentially making them more likely to develop myopia ( 31 , 32 ).…”