Prevalence of Color Blindness in Iranian Students: A Meta-analysis

Abstract

Color blindness (color vision deficiency) is a disorder that impairs the true perception of colors. Using the information in this study, appropriate policy can be made to identify high-risk groups, as well as educational policies for families to perform more effective genetic diagnosis methods. This study aims to examine the prevalence of color blindness in Iranian students through a meta-analysis. Articles related to color blindness published between January 1990 and December 2020 were searched in Scopus, Cochrane Library, Web of Science (WoS), Science Direct, Embase, SID, MagIran, IranDoc, Medline, and Google Scholar databases. The keywords used were based on medical subject topics (MeSH Terms) and, after careful review, articles were selected according to varied sections of Participants, Exposure, Comparison, and Outcomes (PECO). Participants: students; Exposure: students with color blindness were examined; Comparison: Students from multiple provinces and regions of Iran were surveyed for color blindness; Outcomes: the pooled prevalence of color blindness in Iranian students reported from different provinces. The prevalence of color blindness in Iranian students was 3.8% (95% CI: 2.7–5.4%). The pooled prevalence of color blindness in Iranian male and female students was 4.7% (95% CI: 3.5–6.4%) and 0.7% (95% CI: 0.3–1.3%), respectively. The pooled prevalence of red–green color blindness (Tritan) was 41.7% (95% CI: 18.9–68.8%). The pooled prevalence of red color blindness (Protan) was 13.9% (95% CI: 7.8–23.8%), and the pooled prevalence of green color blindness (Deutan) based on meta-analysis was 45.3% (95% CI: 29–62.7%). Due to the high prevalence of color blindness in students, especially male students, it is necessary to be screened for through genetic tests in couples before having children.

Keywords:

Color Blindness, Color Vision Deficiency, Iran, Meta-analysis, Prevalence, Students

References
1. Sapkota YD, Adhikari BN, Pokharel GP, Poudyal BK, Ellwein LB. The prevalence of visual impairment in school children of upper-middle socioeconomic status in Kathmandu. Ophthalmic Epidemiol 2008;15:17–23.

2. Dandona R, Dandona L, Srinivas M, Giridhar P, McCarty CA, Rao GN. Population-based assessment of refractive error in India: The Andhra Pradesh eye disease study. Clin Exp Ophthalmol 2002;30:84–93.

3. Hall JE, Guyton AC. Textbook of medical physiology. 11th ed. Vol. 2. Philadelphia, USA: Saunders Co.; 2004. p. 176– 178.

4. Asbury T, Riordan-Eva P. Vaughan & Ashbury’s general ophthalmology. 17th ed. New York, USA: McGraw Hill; 2008. p. 302–312.

5. Birch J. Worldwide prevalence of red-green color deficiency. J Opt Soc Am A Opt Image Sci Vis 2012;29:313–320.

6. Ong CW, Tan MC, Lam M, Koh VT. Applications of extended reality in ophthalmology: Systematic review. J Med Internet Res 2021;23:e24152.

7. Watane A, Kalavar M, Chen EM, Mruthyunjaya P, Cavuoto KM, Sridhar J, et al. Medical malpractice lawsuits involving ophthalmology trainees. Ophthalmology 2021;128:938– 942.

8. Chia A, Gazzard G, Tong L, Zhang X, Sim EL, Fong A, et al. Red–green colour blindness in Singaporean children. Clin Exp Ophthalmol 2008;36:464–467.

9. Rosenberg EA, Sperazza LC. The visually impaired patient. Am Fam Physician 2008;77:1431–1436.

10. Quillen D. On ophthalmology rankings. Ophthalmology 2019;126:1346–1349. 11. Fleming Fall L. Color blindness. Michigan, USA: Gale Encyclopedia of Medicine; 2002. p. 293–297.

12. Drover JR, Kean PG, Courage ML, Adams RJ. Prevalence of amblyopia and other vision disorders in young Newfoundland and Labrador children. Can J Ophthalmol 2008;43:89–94.

13. Chen PL, Chen JT, Tai MC, Fu JJ, Chang CC, Lu DW. Anisometropic amblyopia treated with spectacle correction alone: Possible factors predicting success and time to start patching. Am J Ophthalmol 2007;143:54–60.

14. Matsuo T, Matsuo C, Matsuoka H, Kio K. Detection of strabismus and amblyopia in 1.5- and 3-year-old children by a preschool vision-screening program in Japan. Acta Med Okayama 2007;61:9–16.

15. Kazeminia M, Abdi A, Shohaimi S, Jalali R, Vaisi-Raygani A, Salari N, et al. Dental caries in primary and permanent teeth in children’s worldwide, 1995 to 2019: a systematic review and meta-analysis. Head Face Med 2020;16:22.

16. Farokhfar A. Prevalence of color blindness in the primary school students in Sari Township 1999. J Mazandaran Univ Med Sci 2001;11:57–62.

17. Mehrpour S, Khalaj M, Zeiaeiha M, Mohammadi Zaesi E. Study of the prevalence of congenital color blindness in students aged 7 to 11 in Qazvin in 1988-89. J Edrak 2016;11:4–12.

18. Khataminia GH, Dejagah H, Kazemi M. Determining the prevalence of congenital color blindness in high school students in Ahvaz. Sci J Med 2006;5:489–493.

19. Samadi Aydanlo SN. Prevalence of blindness among high school students in Urmia. Sci J Med Syst Org Islamic Repub Iran 2011;29:157–161.

20. Nabavizade SH, Nejabat M. Prevalence of blindness among middle school students in Yasuj. Yasuj J Med Sci 2000;5:18–24.

21. Rezaei Shekveh A, Najafi AH. Prevalence of color vision deficiency in male students in Tehran. J Islamic Azad Univ 2006;16:207–210.

22. Ostadi Moghaddam H, Azimi A, Heravian J, Yekta A, Sharifi F, Khabazkhoob M, et al. The prevalence of congenital color blindness and its effect on contrast sensitivity and depth perception. Mashhad J Paramed Sci Rehabil 2011;1:47–52.

23. Omidian J. Prevalence of congenital hereditary color blindness in primary school students in Kermanshah during 1998–1999. Bina 2000;4;325–330.

24. Ramezani A. A study of prevalence of congenital color - Blindness, among school students in Hamadan City in 1995–1996. Avicenna J Clin Med 2000;7:50–56.

25. Hossaini M, Ghadamaee M, Bagherzadeh MR. Prevalence of color blindness in middle school male students in Zanjan 2002. Iran J Ophthalmol 2006;19:55–62.

26. Azarian GHR, Nasrollahi K, Zandi AR. Prevalence of color blindness in students: A study in schools in Isfahan – 1999. Res Med Sci 2001;6:109–110.

27. Hashemi H, Fotouhi A, Mohammad K. The Tehran Eye Study: Research design and eye examination protocol. BMC Ophthalmol 2003;3:8.

28. Rosenberg EA, Sperazza LC. The visually impaired patient. Am Fam Physician 2008;77:1431–1436.

29. Shrestha RK, Joshi MR, Shakya S, Ghising R. Color vision defects in school going children. JNMA J Nepal Med Assoc 2010;50:264–266.

30. 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;17:428–432.

31. Yasmin A, Janan N, Akhter R. Assessment of color blindness and erythrocyte G6PD enzyme status among the school children of Dhaka City. J Bangladesh Soc Physiol 2009;4:64–70.

32. Gordon N. Colour blindness. Pub Health 1998;112:81–84.

33. Kherumian R, Baudry C, Lacorne J, Moullec J. The frequency of dyschromatopsias in France. Presse Med 1956;64:303–304.

34. Lampert EJ, Andorra M, Torres-Torres R, Ortiz-Pérez S, Llufriu S, Sepúlveda M, et al. Color vision impairment in multiple sclerosis points to retinal ganglion cell damage. J Neurol 2015;262:2491–2497.

35. Zein ZA. Gene frequency and type of colour blindness in Ethiopians. Ethiop Med J 1990;28:73–75.

36. Choi TB, Lee DA, Oelrich FO, Amponash D, Bateman JB, Christensen RE. A retrospective study of eye disease among first grade children in Los Angeles. J Am Optom Assoc 1995;66:484–488.

37. Kim HB, Lee SY, Choe JK, Lee JH, Ahn BH. The incidence of congenital color deficiency among Koreans. J Korean Med Sci 1989;4:117–120.

38. Citirik M, Acaroglu G, Batman C, Zilelioglu O. Congenital color blindness in young Turkish men. Ophthalmic Epidemiol 2005;12:133–137.

39. Osuobeni EP. Prevalence of congenital red-green color vision defects in Arab boys from Riyadh, Saudi Arabia. Ophthalmic Epidemiol 1996;3:167–170.

40. Cabrero FJ, Ortiz MA, Mesa MS, Fuster V, Moral P. Redgreen colour blindness in the Tormes-Alberche Valley (Avila-Central Spain). Anthropol Anz 1997;55:295–301.