Exploring practitioner colour blindness in everyday practice

To the Editor: Most of us in the medical profession would have had encounters with colour blind doctors at some stage, perhaps unknowingly. Colour blindness, more formally known as congenital colour vision deficiency (CVD), affects 8% of males and 0.4% of females.1 For those of us who perceive the world in a different spectrum, tasks involving colour in the workplace may provoke anxiety.2

One could argue that the high prevalence of CVD among males is indicative of a biological advantage that is yet to be identified, but my personal experience of living with deuteranopia (red–green CVD) and that described by others suggest that doctors with CVD face various challenges in recognising clinical features involving colour.3 Some common situations that require colour perception include identifying red throats, red tympanic membranes, rashes, cyanosis, paleness, infected wounds, jaundice, melaena and haematemesis. Correlating colours on a urine dipstick chart and analysing histopathology slides can sometimes prove perplexing as well. The solution is often to seek a second opinion, but this is not always practical or desirable. There may be times when pride and the pressure to appear “normal” to peers can result in doctors reporting or even acting upon clinical signs or test results without verifying them with colleagues with normal colour vision.

In Australia, junior doctors and medical students with CVD have had the fortune of finding themselves unrestricted in their pursuit of any medical career. Regrettably, the situation elsewhere in the developed world has not been the same. Until recently, in Japan, high school students with CVD were often denied entry into medical school for fear that they might end up on the wrong side of the Hippocratic Oath.4 This regulation was lifted once it became apparent that doctors with CVD were routinely negotiating the wards in other countries without adverse outcomes.

From a practical perspective, medical students with CVD would benefit greatly from career counselling at an early stage of their education. Ophthalmology, pathology and general practice might not be the best careers to pursue, but other options, such as psychiatry, appear to have little involvement with colour.