Colour vision deficiencies (CVDs) can be categorised as being congenital or acquired. Some CVDs are already present at birth, as inherited conditions that are the result of changes at the photo-pigment level and are non-pathological, incurable and do not change over time. Examples are red-green defects which are inherited as an X-linked recessive trait. Acquired CVD develops secondary to ocular and systemic conditions or as a side effect of certain medications or sometimes toxic effects of chemicals, and trauma and ageing can also be important in some CVDs.

The evaluation of colour vision and discrimination of an individual forms an integral part of a routine eye and vision examination. With the increasing prevalence of inherited colour vision deficiencies, defects of colour vision can be detected in an optometric practice by means of a variety of tests available. The present article comprises an overview of the design and function of a selection of colour vision tests that are administered manually and, in some cases, have been modified to form a computerised version.

Objective The NETRA (Near Eye Tool for Refractive Assessment) is a smartphone-based refractive tool that allows for self-evaluation of refractive error. This study investigates the validity of the NETRA with and without cycloplegia to non-cycloplegic subjective refractions (SR). Methods and analysis Participants underwent NETRA measurements without cycloplegia, and again after the administration of cycloplegia (cyclopentolate hydrochloride 1%). Non-cycloplegic SR were also performed. Variation of refractive measurements in symmetric dioptric power space were investigated using stereo-pair comets, hypothesis tests for variances and means. Bland-Altman plots were applied to better understand validity of the NETRA against non-cycloplegic SR. Coefficients of repeatability and intraclass correlation coefficients were also determined. Results The sample included 22 women (64.7%) and 12 men (35.3%); most were indigenous Africans (52.9%) with mean age and SD of 20.24±1.95 years. Variation of refractive measurements were mainly stigmatic (spherical), and variation of NETRA measurements decreased after cycloplegia. The pre-cycloplegia NETRA measurements (and their means) for the right and left eyes were more negative (myopic) in power than the post-cycloplegia NETRA measurements and means. On average, eyes were approximately 1.25 D more myopic with the NETRA without cycloplegia. With cycloplegia, NETRA results were in closer agreement with non-cycloplegic SR for the same eyes. Conclusion NETRA validity to SR, even in the absence of cycloplegia, suggests the instrument may be useful in geographical regions where self-refractions might be potentially helpful in addressing limitations in eye and vision care.

Myopia is a global healthcare concern and effective analyses of dioptric power are important in evaluating potential treatments involving surgery, orthokeratology, drugs such as low-dose (0.05%) atropine and gene therapy. This paper considers issues of concern when analysing refractive state such as data normality, transformations, outliers and anisometropia. A brief review of methods for analysing and representing dioptric power is included but the emphasis is on the optimal approach to understanding refractive state (and its variation) in addressing pertinent clinical and research questions. Although there have been significant improvements in the analysis of refractive state, areas for critical consideration remain and the use of power matrices as opposed to power vectors is one such area. Another is effective identification of outliers in refractive data. The type of multivariate distribution present with samples of dioptric power is often not considered. Similarly, transformations of samples (of dioptric power) towards normality and the effects of such transformations are not thoroughly explored. These areas (outliers, normality and transformations) need further investigation for greater efficacy and proper inferences regarding refractive error. Although power vectors are better known, power matrices are accentuated herein due to potential advantages for statistical analyses of dioptric power such as greater simplicity, completeness, and improved facility for quantitative and graphical representation of refractive state.

This narrative review explores the relationship between African facial anthropometry and spectacle frame design. Despite the global eyewear market’s growth, a significant gap exists in designs accommodating African facial features. Through a comprehensive literature analysis, this review examines key anthropometric measurements relevant to eyewear fit across diverse African populations, current challenges in spectacle frame design, and emerging solutions. Findings reveal persistent underrepresentation of African facial measurements in global design standards, leading to poor fit, discomfort, and reduced compliance. The review identifies opportunities for innovative frame designs, material selection, and manufacturing approaches that could better serve African populations. Recommendations include increased anthropometric research across different African ethnicities, integration of digital technologies, and development of region-specific design parameters. This review contributes to the growing body of knowledge advocating for more inclusive and culturally appropriate eyewear solutions.

Background: Measuring contrast sensitivity for each of the three cone types separately allows for a more precise and clinically valuable assessment of color vision. This study examined how pupil size affects cone contrast sensitivity (CCS). Methods: This study included 50 participants of equal gender. The mean age was 20.88 (±1.8) years. Using the ColorDx, a Landolt C stimulus of various sizes in an adaptive screening mode, we sequentially determined contrast sensitivity for long-, medium-, and short-wavelength stimuli. Two consecutive measurements were performed on participants, one with their natural pupil size (range 4–5 mm diameter) and, subsequently, with six artificial eye pupils (1 mm to 6 mm). Results: Generally, the 1 mm pupil size caused the greatest reduction in contrast sensitivity for two of the three cones. There was no significant main effect of sex (F = 0.96, df = 1, p = 0.32) on the log cone contrast sensitivity of the L-cone. However, pupil size had a significant main effect (F = 116.1, df = 6, p < 0.001). Within each sex, the log CCS was significantly reduced as the pupil size decreased compared with the normal pupil size. Conclusions: New technologies that assess individual cone pathway functions could potentially assist in identifying early or progressive conditions that may impact color vision pathways from the retina to the brain. Standardized protocols—such as controlled retinal illumination—are critical to avoid misinterpretation.