We assessed chromatic discrimination in multiple sclerosis (MS) patients both with (ON) and without (no ON) a history of optic neuritis using the Cambridge color test (CCT). Our goal was to determine the magnitude and chromatic axes of any color vision losses in both patient groups, and to evaluate age-related changes in chromatic discrimination in both patient groups compared to normals. Using the CCT, we measured chromatic discrimination along the protan, deutan and tritan axes in 35 patients with MS (17 ON eyes) and 74 age matched controls. Color thresholds for both patient groups were significantly higher than controls' along the protan and tritan axes (p < 0.001). In addition, the ON and no-ON groups differed significantly along all three-color axes (p < 0.001). MS patients presented a progressive color discrimination impairment with age (along the deutan and tritan axes) that was almost two times faster than controls, even in the absence of ON. These findings suggest that demyelinating diseases reduce sensitivity to color vision in both red-green and blue-yellow axes, implying impairment in both parvocellular and koniocellular visual pathways. The CCT is a useful tool to help characterize vision losses in MS, and the relationship between these losses and degree of optic nerve involvement.

This longitudinal study addresses the reversibility of color vision losses in subjects who had been occupationally exposed to mercury vapor. Color discrimination was assessed in 20 Hg-exposed patients (mean age = 42.4 ± 6.5 years; 6 females and 14 males) with exposure to Hg vapor during 10.5 ± 5.3 years and away from the work place (relative to 2002) for 6.8 ± 4.2 years. During the Hg exposure or up to one year after ceasing it, mean urinary Hg concentration was 47 ± 35.4 μg/g creatinine. There was no information on Hg urinary concentration at the time of the first tests, in 2002 (Ventura et al., 2005), but at the time of the follow-up tests, in 2005, this value was 1.4 ± 1.4 μg/g creatinine for patients compared with 0.5 ± 0.5 μg/g creatinine for controls (different group from the one in Ventura et al. (2005)). Color vision was monocularly assessed using the Cambridge Colour Test (CCT). Hg-exposed patients had significantly worse color discrimination (p < 0.02) than controls, as evaluated by the size of MacAdam's color discrimination ellipses and color discrimination thresholds along protan, deutan, and tritan confusion axes. There were no significant differences between the results of the study in Ventura et al. (2005) and in the present follow-up measurements, in 2005, except for worsening of the tritan thresholds in the best eye in 2005. Both chromatic systems, blue-yellow and red-green, were affected in the first evaluation (Ventura et al., 2005) and remained impaired in the follow-up testing, in 2005. These findings indicate that following a long-term occupational exposure to Hg vapor, even several years away from the source of intoxication, color vision impairment remains irreversible.

Color vision impairment was examined in patients with type 2 diabetes mellitus (DM2) without retinopathy. We assessed the type and degree of distortions of individual color spaces. DM2 patients (n= 32), and age-matched controls (n= 20) were tested using the Farnsworth D-15 and the Lanthony D-15d tests. In addition, subsets of caps from both tests were employed in a triadic procedure (Bimler & Kirkland, 2004). Matrices of inter-cap subjective dissimilarities were estimated from each subject's “odd-one-out” choices, and processed using non-metric multidimensional scaling. Two-dimensional color spaces, individual and group (DM2 patients; controls), were reconstructed, with the axes interpreted as the R/G and B/Y perceptual opponent systems. Compared to controls, patient results were not significant for the D-15 and D-15d. In contrast, in the triadic procedure the residual distances were significantly different compared to controls: right eye,P= 0.021, and left eye,P= 0.022. Color space configurations for the DM2 patients were compressed along the B/Y and R/G dimensions. The present findings agree with earlier studies demonstrating diffuse losses in early stages of DM2. The proposed method of testing uses color spaces to represent discrimination and provides more differentiated quantitative diagnosis, which may be interpreted as the perceptual color system affected. In addition, it enables the detection of very mild color vision impairment that is not captured by the D-15d test. Along with fundoscopy, individual color spaces may serve for monitoring early functional changes and thereby to support a treatment strategy.

It is known that, although the level of light is the primary determinant of pupil size, cognitive factors can also affect pupil diameter. It has been demonstrated that photographs of the sun produce pupil constriction independently of their luminance and other low-level features, suggesting that high-level visual processing may also modulate pupil response. Here, we measure pupil response to artistic paintings of the sun, moon, or containing a uniform lighting, that, being mediated by the artist’s interpretation of reality and his technical rendering, require an even higher level of interpretation compared with photographs. We also study how chromatic content and spatial layout affect the results by presenting grey-scale and inverted versions of each painting. Finally, we assess directly with a categorization test how subjective image interpretation affects pupil response. We find that paintings with the sun elicit a smaller pupil size than paintings with the moon, or paintings containing no visible light source. The effect produced by sun paintings is reduced by disrupting contextual information, such as by removing color or manipulating the relations between paintings features that make more difficult to identify the source of light. Finally, and more importantly, pupil diameter changes according to observers’ interpretation of the scene represented in the same stimulus. In conclusion, results show that the subcortical pupillary response to light is modulated by subjective interpretation of luminous objects, suggesting the involvement of cortical systems in charge of cognitive processes, such as attention, object recognition, familiarity, memory, and imagination.