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I cannot see the Colours of the Rainbow: 

Colour Blindness in Medical Profession

Dr Sampurna Roy MD                     July 2016   



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The world would be a very dull place if we saw everything in black and white.

The blue skies flecked with clouds, flame coloured sunsets, beautiful rainbow, the green grass and leaves and the colours of flowers, birds, insects make up much of the beauty of nature.

Human eye can detect various combinations of red, green and blue.

People with abnormal colour vision often report difficulty seeing coloured fruits and flowers which suggests they have a diminished capacity for visual identification when target objects are marked out by colour.

Colour plays an important role in medical profession.

Is it possible to be a histopathologist with colour vision deficiency? Yes, there are many colour blind doctors still struggling and carrying out their professional duties efficiently.

In an article Dr Keene stated that Red-Green color impairment is sex linked with the vast majority being male.

It is a variable trait and patients may have slight color vision deficiency to rare cases where there is complete lack of color perception.

In 75% of cases the green colour is diminished and in remaining patients the red colour is diminished.

The deficiency results in reds and greens being perceived as shades of yellow.

A study by Landini et al explained that individuals with red-green colour blindness commonly experience great difficulty in differentiating between certain histological stain pairs, like haematoxylin-eosin (H and E).

It is likely that a histopathologist with colour vision deficiency will make errors in the interpretation of histopathology slides.

Digital enhancement  of haematoxylin and eosin stained histological images using special methods helped the colour blind pathologists to clearly identify the colour.

The benefits of these methods were tested in volunteers with normal vision and with red-green colour blindness using a variety of haematoxylin and eosin stained tissue sections paired with their enhanced versions. 

Colour vision deficiency can be divided into congenital and acquired forms.

Hereditary red-green color vision defects is usually noted in males. The condition is not accompanied by ophthalmologic or other associated clinical abnormalities. In most of the cases the patients have no problem in naming colours. 

Inherited colour vision deficiencies most often result from the mutations of genes that encode cone opsins.

Cone opsin genes are linked to chromosomes 7 (the S or "blue" gene) and X (the L or "red" gene and the M or "green" gene).

Colour is often used as a sign in medicine.

Some common difficulties reported by clinicians were in recognizing body color changes (pallor, cyanosis, jaundice, rashes, erythema of skin), colorful charts, slides, test-strips for blood and urine, body products: blood or bile in urine, faeces, sputum, vomit, and identification of lesions in the mouth and throat.

Medical schools should make sure that students with congenital colour vision deficiencies are aware of their deficiency and know the severity of the condition.

This will help them in future to take special care in clinical practice.

If you are working with a colour blind colleague please show compassion, give them special attention and help them to carry on their professional duty.

[ Note:   In "Confessions of a colour blind physician" Dr Spalding described his experiences due to his inherited colour vision deficiency, as a child, as student and as a medical practitioner, when he had certain difficulties in clinical work.

It is suggested scientists and medical practitioners with colour vision deficiencies need more understanding of each other's discipline if progress is to be made.

The advantages of screening of medical students and advising those found to have a deficiency are discussed and lines of research are proposed. ]


Further reading:

Red-Green Color Vision Defects.

Color-blind physicians and the detection of blood in body products.

Confessions of a colour blind physician

Colour blind artists: do the Vischeck transformations work?

The doctor with an inherited defect of colour vision: effect on clinical skills.

Doctors and the assessment of blood glucose testing sticks: does colour blindness matter?

Medical students and congenital colour vision deficiency: unnoticed problems and the case for screening.

The description of physical signs of illness in photographs by physicians with abnormal colour vision.

Color blind physicians--is it a problem?.

Impact of color blindness on recognition of blood in body fluids.


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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)







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