Attachment 12 Color vision test SOP

Understanding Long-term Respiratory Morbidity in Former Styrene-exposed Workers: Medical Survey

Attachment 12 Color vision test SOP

OMB: 0920-1332

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Attachment 12


Color Test Instructions

(Farnsworth/Lanthony Combined D-15 Test)





























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Form Approved

OMB NO. 0920-xxxx

Expiration Date: xx/xx/20xx



Lighting conditions: Check the lighting in the exam room prior to the start of the survey and throughout the day.

    1. Position the incandescent bulb at a 45 degree angle to the surface where the participant will be working on the color test. Make sure it is an appropriate distance

      1. 60 watt - 21cm

      2. 75 watt- 24 cm

      3. 100 watt – 36 cm

    2. Hold the light meter two inches from the center of the F.A.C.T. chart.

    3. The needle on the light meter should be in the green area.

    4. If the needle on the light meter is not in the green area, adjust the room illumination (such as with a lamp behind the participant’s shoulder or hooded in a manner to avoid direct glare. The participant should not be able to see the light bulb). If there is an issue with illumination, please do not perform the vision testing until this is fixed.


Handling of caps/glasses: Keep the caps in the covered box when not using them. Exposure to room light or sunlight can cause fading. Do not touch the color surfaces of the caps; oil and dirt can cause them to discolor. Keep the glasses in the UV protective sleeve when not using them.


Preparation before subject begins: Wipe down the earpieces and bridge of the glasses with a gauze pad wetted with lens cleaner, or lens cleaner pad. The manufacturer recommends not cleaning the lenses more than necessary—if there are fingerprint smudges that may impact the subject’s visibility, then wipe the lenses with lens cleaner, gently. Remove the cover from the color cap box and slide (without touching the color parts!) the color caps onto the table/desk. Arrange the caps randomly.


Instructions to subject:

  1. Please put these glasses and gloves on.”

  2. There is one cap in the box”(point it out).

  3. Locate the cap in this group” (pointing to loose caps on table) “that is closest in color to the one in the box. Move the selected cap next to the starting one.”

  4. Remind them not to touch the color top of the caps, only the black sides.

  5. Now, continue to select the cap that is next closest in color to the last one, and move them into the box.”

  6. Once all caps are back in the box, they are given a chance to make any re-arrangements they would like.


After the subject is done:

  1. Slide the top back onto the box.

  2. Flip the box over to reveal the numbers on the bottom sides of the caps.

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    Public reporting burden of this collection of information is estimated to average 5 mins per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).



    On the data collection form, record the 15 numbers in the cells provided, starting with the starter cap on the far left.

  4. If they got them all in the right numeric order, just check the blank on the data collection form where it says “Check here if all caps in correct numeric order (no need to fill in table).”



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWJA6
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File Created2022-01-24

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