Incidence of Myopia in High School Students with and without Red-Green Color Vision Deficiency

PURPOSE. To investigate the influence of color vision on myopia development by testing refraction error and axial length of the eye for high school students with and without color vision deficiency (CVD). METHODS. A school-based cross-sectional, cluster sample study was conducted to test the color vision and refractive error of 16,539 high school students. Students were screened for CVD using a pseudoisochromatic plate. CVD was confirmed in students failing the test using a Farnsworth- Munsell 100-Hue Test which also served to classify the subtype (protan or deutan). Three classmates of each CVD subject, matched in five myopia risk factors, were chosen to form the normal color vision (CN) control group. Ophthalmic examinations were performed to determine refractive status and axial length. RESULTS. Of the students, 309 were found to have red-green CVD and 927 were selected as the CN control group. The prevalence of myopia in the CVD group (45.6%) was significantly lower than that of the CN group (65.8%; P < 0.001). The CVD group was also less myopic in refraction (P < 0.001) than CN, and protan subjects had shorter axial lengths than those in the control group (P = 0.007). CONCLUSIONS. Color vision deficiencies appear to influence the development of myopia. The observed lower incidence of myopia in people with CVD may be linked to the reduced functionality of the L/M chromatic mechanism. (Invest Ophthalmol Vis Sci. 2009; 50: 1598-1605) DOI:10.1167/iovs.07-1362