Eye Doctors Still Use This 100-Year-Old Test for Color Blindness

You may have seen them at your ophthalmologist's office: large circular diagrams made up of colored dots. People with normal vision are able to discern a number among the dots of contrasting colors. People who are color blind might see only a field of spots.

These elegant, deceptively modern drawings were published 100 years ago by a Japanese ophthalmologist, Shinobu Ishihara. Thanks to the designs' simplicity and diagnostic accuracy, the Ishihara test is still the most popular and efficient way to identify patients with color vision deficiencies.

Born in Tokyo in 1879, Ishihara studied medicine at the prestigious Tokyo Imperial University on a military scholarship, which required him to serve in the armed forces. After graduating in 1905, he worked for three years as a physician specializing in surgery in the Imperial Japanese Army, and then returned to the university for postgraduate studies in ophthalmology. In his research, Ishihara focused on identifying and recruiting soldiers with superior vision, thereby increasing the overall effectiveness of the military. And that became of prime importance to Japan beginning in 1914.

As World War I spread across Europe, Asia, and the Pacific, the Japanese army asked Ishihara to develop a better way to screen draftees for color vision problems. The most popular method at the time was the Stilling test, invented by German ophthalmologist Jakob Stilling in 1878 as the first clinical color vision test. (Previous tools had asked patients to identify the colors of wool skeins or illuminated lanterns—useful skills for sailors and railway conductors, but an imprecise method for diagnosing vision issues.)

"Though popular, 'the Stilling' retained a distinctly 19th-century flavor, more treatise-like and less diagnostically incisive," according to Eye magazine.


Shinobu Ishihara
Wellcome Images // CC BY 4.0

Japanese army officials requested a new diagnostic tool that was easier to administer and interpret. The test Ishihara began to develop was based, like Stilling's, on the principle of pseudo-isochromatism—a phenomenon in which two or more colors are seen as the same (or isochromatic) when they're actually different. A person with normal vision could easily see the difference, while people with red-green deficiency, the most common form of color blindness, would have difficulty distinguishing those two opposing colors. Those with blue-yellow color blindness, a less common type, would have a hard time discerning reds, greens, blues, or yellows.

Ishihara hand-painted circular designs comprised of small dots of different areas and colors so that variations in the design could be discerned only by color and not shape, size, or pattern. Hidden in the field of dots was a figure of a contrasting color that people with normal vision could see, while those with deficiencies could not. Other plates in the series were designed to show figures that would be visible only to people with deficiencies. When physicians displayed the diagrams, patients said or traced the visible figure within the circle without needing to use ambiguous color names, which standardized the possible results.

The earliest sets of Ishihara plates, produced in 1916, were reserved exclusively for the army's use and featured Japanese characters within the diagrams. In 1917, in an effort to sell the series internationally, Ishihara redesigned it with the now-familiar Arabic numerals and published a set of 16 plates as Tests for Colour Deficiency.

The tests were adopted throughout the world beginning in the early 1920s, and eventually grew into a set of 38 plates. But their popularity almost led to their undoing. Unauthorized publishers printed their own version of the plates to meet demand, throwing the accuracy of the diagnostic colors into doubt. "The plates have been duplicated along with an easily memorized key by cheap color processes in the tabloid press, and exposed in public places, reducing the fifth edition [of the collection] to a parlor game," one psychologist warned in the Journal of the Optical Society of America in 1943.

Despite those obstacles, the tests proved indispensable for both practicing physicians and researchers. Ishihara continued to refine the designs and improve the color accuracy of the images into the late 1950s, while he also served as the chair of the ophthalmology department and then dean of the medical school at Tokyo Imperial University. In addition to Tests for Colour Deficiency, he also published an atlas, textbook, lectures, and research studies on eye diseases. But he is remembered most for the iconic charts that seamlessly blend art and science.

Why Is Pee Yellow?

Chloe Effron
Chloe Effron

WHY? is our attempt to answer all the questions every little kid asks. Do you have a question? Send it to why@mentalfloss.com.

Your body is kind of like a house. You bring things into your body by eating, drinking, and breathing. But just like the things we bring home to real houses, we don’t need every part of what we take in. So there are leftovers, or garbage. And if you let garbage sit around in your house or your body for too long, it gets gross and can make you sick. Your body takes out the garbage by peeing and pooping. These two things are part of your body’s excretory system (ECKS-krih-tore-eee SISS-tem), which is just a fancy way of saying “trash removal.” If your body is healthy, when you look in the toilet you should see brown poop and yellow pee.

Clear, light yellow pee is a sign that your excretory system and the rest of your body are working right. If your pee, or urine (YER-inn), is not see-through, that might mean you are sick. Dark yellow urine usually means that you aren’t drinking enough water. On the other hand, really pale or colorless pee can mean you might be drinking too much water! 

Your blood is filtered through two small organs called kidneys (KID-knees). Remember the garbage we talked about earlier? The chemicals called toxins (TOCK-sins) are like garbage in your blood. Your kidneys act like a net, catching the toxins and other leftovers and turning them into pee.

One part of your blood is called hemoglobin (HEE-moh-gloh-bin). This is what makes your blood red. Hemoglobin goes through a lot of changes as it passes through your body. When it reaches your kidneys, it turns yellow thanks to a chemical called urobilin (yer-ah-BY-lin). Urobilin is kind of like food coloring. The more water you add, the lighter it will be. That's why, if you see dark yellow pee in the toilet, it's time to ask your mom or dad for a cup of water. 

To learn more about pee, check out this article from Kids Health. 

Flashing Status Symbols Won’t Impress New Friends—and May Even Backfire

iStock
iStock

Trying to keep up with the Joneses isn’t a very effective way of making friends. As The Outline reports, a recent study in the journal Social Psychological and Personality Science suggests that flashing status symbols makes people less likely to want to be your friend.

While some may feel like sporting a luxury watch or designer clothes will draw people toward them, it actually does the opposite, making you a less attractive potential friend, according to a trio of researchers from Michigan, Singapore, and Israel. Over the course of six different experiments, the researchers found that study participants tended to think that high-status markers like fancy cars would help them make new friends. The trend stayed true across both participants recruited using Amazon Mechanical Turk and upscale shoppers stopped for a survey in a high-income suburb.

People thought that showing up to an outdoor wedding in a luxury car or going out to a downtown bar wearing a fancy brand-name watch would lead people to be more attracted to them as potential friends, compared to someone driving a basic car or wearing a generic watch. Yet participants also rated themselves as being more willing to befriend someone with generic clothes and cars than someone who flashed designer goods.

The paradox makes a little more sense if you go back to the idea of “keeping up” with our neighbors. People want to look high status in comparison to others. They don’t want to hang out with people who are flashing around luxury goods—they want to be the flashier ones.

[h/t The Outline]

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