The Evolution of Color Vision Testing (Ishihara, HRR, Dvorine, and more)

The Evolution of Color Vision Testing

German researcher Jakob Stilling, developed "Stilling's Colour Table" in 1877, the first color vision test based on pseudoisochromatic plates. Jakob Stilling

He developed the plates right after Sweden's infamous Lagerlunda train wreck in 1875. Two trains had collided, possibly because an engineer had been unable to distinguish between red and green signal lights. 

Dr. Shinobu Ishihara, a Japanese ophthalmologist, later created the Ishihara Color Vision Charts in 1917 during his tenure at the University of Tokyo.

Dr. Shinobu Ishihara

The Ishihara eventually became more popular than the Stillings color vision test and pretty much became the international standard. In 1941 Japan attacked Pearl Harbor. The commencement of World War II resulted in the Ishihara no longer being able to be bought in America.  Because different occupations and the United States Military still required color vision testing, the American Optical Company attempted printing replicas of the Ishihara and even Stillings test plates without much success.  Today, others are also attempting to reproduce the Ishihara - also without much success.  The ability to accurately reproduce any color vision test is no small feat and requires a plethora of knowledge on the topic.

Israel Dvorine, an optometrist, was the first American in the early part of the 1940’s to also develop a test for colorblindness.  

Dr. Israel Dvorine

He initially used water colors when designing his test plates. He later had to delve into and learn the intricacies of the printing process so as to reproduce his test plates on a printing press.

The American Optical Hardy-Rand-Rittler (AOHRR) pseudoisochromatic plates were first published in 1955 having been developed from the handmade AO-HRR Polychromatic plates. 

American Optical HRR, AOHRR, HRR

When the second edition print run was exhausted in 1957, American Optical did not invest in the production of another edition, which would have meant replacing superseded printing inks1.

 After getting a note from his son’s the first-grade school nurse in 1993 saying his 6-year-old was colorblind, Terrace L. Waggoner, an American optometrist, designed Color Vision Testing Made Easy (CVTME) incorporating a circle, star, and square using colored sheets from Munsell. As Dvorine, Waggoner too had to delve into and learn the intricacies of the printing process so as to reproduce his test plates on a printing press.

 Dr. Terrace Waggoner, Color Vision Testing Made Easy, CVTMEColor Vision Testing Made Easy Museum

At the time, optometrists, school nurses, and Waggoner himself, waited until children were at least six years old and knew their numbers before testing for any kind of color vision deficiency. CVTME has been validated and is currently the international gold standard to evaluate pediatric patients as young as 3 years old.

Richmond International, Inc. printed and copyrighted a third edition HRR in 1991, but Steven Dain concluded that the chromaticity’s of the third edition HRR were exceptionally poorly matched and that the edition was a pale imitation of the real thing.2 After selling the third edition for over a decade, the company in 2004 had the plates re-engineered to produce the present 4th Edition.  Two years earlier, in 2002, Waggoner published a modified HRR with additional (Ishihara style) plates and the tetartan confusion figures removed. During the same time frame, Waggoner also designed and printed the Waggoner PIP24 Plate Edition – validated by the U.S. Military, FAA, along with other institutes.

The latest evolution in color vision testing is computerized color vision testing – but that’s a future blog.

  2. Published online by Cambridge University Press:  05 April 2005