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

Abstract

Abstract Objective To examine the association of color vision deficiency (CVD) with other ophthalmic disorders including ametropia, amblyopia and strabismus in a large population study. Methods The retrospective, cross-sectional study included 916 388 Israeli army male recruits that had their pre-military medical assessment at the age of 16 to 18 years from 2000 to 2020. We examined the prevalence of ophthalmic disorders including amblyopia, strabismus and ametropia in army recruits with CVD compared to all other recruits with normal color vision. Demographic and socioeconomic data were also collected. Results The prevalence of amblyopia (1.12% vs. 0.71%, p < 0.001), strabismus (1.10% vs. 0.82%, p < 0.001), and ametropia (moderate – less than 6.00 diopters, 35.80% vs. 30.42%, p < 0.001, and high, 3.01% vs. 2.29%, p < 0.001) were all higher in the 37 029 (4.04%) army recruits with CVD compared with individuals with normal color vision. CVD was more common in individuals with a higher socioeconomic status (high 4.32% vs. low 3.86%, p < 0.001) and varied according to recruits’ origin. It was most frequent in individuals whose parents were born in former Soviet Union (4.81%) compared with other European countries (4.55%), North America (4.26%), Asia (3.27%) and Ethiopia (2.19%). Conclusions CVD is associated with increased risk of vision difficulties that are not related to color vision impairment alone. Screening in childhood for color vision deficiency could help in avoiding preventable vision loss.