Quantifying color vision changes associated with cataracts using cone contrast thresholds

Urmi Mehta, Anna Diep, Kevin Nguyen, Bryan Le, Clara Yuh, Caroline Frambach, John Doan, Ang Wei, Anton M. Palma, Marjan Farid, Sumit Garg, Sanjay Kedhar, Matthew Wade, Kailey A. Marshall, Kimberly A. Jameson, M. Cristina Kenney, Andrew W. Browne

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To evaluate effects of age and simulated and real cataractous changes on color vision as measured by the high-definition cone contrast test (CCT). Methods: Twenty-four healthy volunteers from two cohort studies performed CCT using best-corrected visual acuity, filters, mydriasis, and pinhole correction. Retrospective cross-sectional study of patients seen in eye clinics evaluated the relationship between age and color vision, and age and lens status in 355 eyes. Last, 25 subjects underwent CCT before and after cataract surgery. Results: CCT scores were most reliable in the nonmydriatic condition without pinhole correction. Progressively dense brown filters produced small decreases in S-cone sensi-tivity. Linear regression analysis of phakic subjects showed a decline for all cone classes with age. Rate of decline was greater for S-cones (slope = −1.09; 95% confidence interval [CI], −1.30 to 0.86) than M-cones (slope =−0.80; 95% CI, −1.03 to −0.58) and L-cones (slope = −0.66; 95% CI, −0.88 to −0.44). CCT scores increased for S-cones but reduced for L-and M-cones in pseudophakic subjects compared with phakic patients. CCT scores after cataract surgery increased for S-cones, M-cones, and L-cones by 33.0 (95% CI, 8.6 to 57.4), 24.9 (95% CI, 3.8 to 46.0), and 22.0 (95% CI, −3.2 to 47.3), respectively. Conclusions: CCT assessment allows for clinically practical quantitation of color and contrast vision improvement after cataract surgery and aging patients who note poor vision despite good visual acuity. Translational Relevance: CCT testing, which quantifies hereditary and acquired color deficiency, can also quantify the degree of cataract severity and, combined with other parameters, can provide more precise guidance for cataract extraction to optimize patient care.

Original languageEnglish
Article number11
Pages (from-to)1-10
Number of pages10
JournalTranslational Vision Science and Technology
Issue number12
StatePublished - 2020
Externally publishedYes


  • Age-related decline in color vision
  • Color vision changes associated with aging
  • Color vision changes before and after cataract surgery
  • Cone contrast test
  • Cone contrast threshold


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