Dhingra Rajat, Rohatgi Jolly, Dhaliwal Upreet
Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.
Natl Med J India. 2017 Jan-Feb;30(1):30-35.
Colour vision of candidates is tested in many medical colleges in India at the time of admission to undergraduate courses; however, there are no guidelines, and therefore no counselling, on how students with congenital colour vision deficiency (CCVD) should negotiate the medical course, and how best they can practise safely after graduation. Problems in interpreting coloured signs may lead to misdiagnosis. This study aimed to explore difficulties during clinical work that requires colour discrimination, and to offer suggestions on safe practice based on the findings and a review of the literature.
We did a cross-sectional study after obtaining institutional ethical clearance and written informed consent. Thirty volunteer medical students with CCVD (≥3 errors on Ishihara chart) were matched with 30 volunteers from their own batch who made no errors. All participants interpreted colour-dependent clinical and laboratory photographs.
Students with CCVD made more errors (range 5-26; mean [SD] 13.17 [5.873] out of 75 items in 35 colour-dependent photographs) than colour-normal students (range 2-13; mean [SD] 5.53 [3.037], p<0.001). The nature of the errors suggested that medical students with CCVD could have problems in learning histology, pathology, haematology, microbiology, dermatology, paediatrics, medicine, biochemistry and during ophthalmoscopy.
Screening at the time of admission will make students aware of their CCVD status and, through conscious practice thereafter, they may understand their limitations. Faculty could guide and prepare such students for safe practice.
在印度,许多医学院在本科课程招生时会对考生进行色觉测试;然而,对于先天性色觉缺陷(CCVD)的学生应如何应对医学课程,以及毕业后如何安全行医,并没有相关指导方针,因此也没有相应的咨询服务。解读彩色体征时出现的问题可能会导致误诊。本研究旨在探讨在需要辨别颜色的临床工作中所遇到的困难,并根据研究结果和文献综述就安全行医提供建议。
在获得机构伦理批准和书面知情同意后,我们进行了一项横断面研究。30名患有CCVD(石原氏色盲测验表上错误≥3处)的志愿医学生与同届30名无错误的志愿者进行匹配。所有参与者对依赖颜色的临床和实验室照片进行解读。
与色觉正常的学生相比,患有CCVD的学生错误更多(在35张依赖颜色的照片中的75个项目中,错误范围为5 - 26;均值[标准差]为13.17 [5.873]),而色觉正常的学生错误范围为2 - 13;均值[标准差]为5.53 [3.037],p<0.001)。错误的性质表明,患有CCVD的医学生在学习组织学、病理学、血液学、微生物学、皮肤病学、儿科学、医学、生物化学以及眼底镜检查时可能会遇到问题。
入学时进行筛查会让学生了解自己的CCVD状况,此后通过有意识的练习,他们可能会明白自己的局限性。教师可以指导并帮助这些学生安全行医。