Clinical use of the American Optical Company (Hardy, Rand and Rittler) pseudoisochromatic plates for red-green colour deficiency

The efficiency of the American Optical Company (Hardy, Rand and Rittler) (HRR) plates for screening, grading and classifying red-green colour deficiency was examined for 401 male colour deficient subjects previously identified and diagnosed with the Nagel anomaloscope. There were 83 protanopes, 30 protanomalous trichromats, 96 deuteranopes and 192 deuteranomalous trichromats. Screening sensitivity was found to be 100% for dichromats and 96.4% for anomalous trichromats based on one screening error (35 subjects, including 7 dichromats, were identified by a single error). Thirty subjects (13.5%) made errors on screening plates only and were identified as having minimal colour deficiency. The HRR grading system did not distinguish dichromats and anomalous trichromats; 54% of dichromats were graded as having moderate rather than severe colour deficiency. Protan/deutan classification was correct for 95% of subjects who failed grading plates. HRR grades for anomalous trichromats were compared with the anomaloscope matching range and with pass or fail of the D15 test. The results show that only two rather than four grading categories can be distinguished by the HRR plates and that both the D15 and the HRR plates are needed in a vocational test battery to establish the severity of colour deficiency. (C) 1997 The College of Optometrists.