~ (Goon-uTe’ COLORY Number Color Plates 16 color plates for screening protan/deutan (red/green) 2 color plates for screening tritan (blue/yellow) Pediatric Symbols Color Plates 8 color plates for screening protan/deutan (red/green) CE memer agiaiee, wa] (G00D-LITE version 14-2014Pseudoisochromatic Color Vision Test from Good-Lite Plate Description * Plates are numbered at the bottom left and right corners of each page. * Plates 1-18 are numbers to use with children and adults who know their numbers. and are aged 5 years and older. ~ Plates 1-8: Use for screening (Plate 1 is a demonstration card and all children and adults should be able to identify the number on the demo card, regardless of whether a color deficiency is present). ~ Plate 9-15: Optional - Verification plates to use for additional screening or for meeting military and government requirements. ~ Plate 16: Optional - This plate screens for severity of color deficiency. ~ Plate 17-18: Optional - These plates help screen for the tritan type of color deficiency. * Plates 19-26 are LEA Symbols pediatric characters to use with children who do not know their numbers, ~ Plates 19-26: Use for screening (Plate 19 is a demonstration card and all children should be able to identify three symbols on the demo plate, regardless of whether the child has a color deficiency), Lighting * For proper illumination, use natural daylight lamps such as the Foldi™ LED Lamp (#045000), Color Test Daylight lltuminator (#730003) or Twist Portable Lamp (#033700) found on the Good-Lite website for accurate color screening results. These lamps can be found at: www.good-lite.comScreening * Hold plates 24-30 inches from the face and at a right angle to the line of sight. * Allow 3 seconds for identification of each plate. ~ Hesitation is an indication of a color vision deficiency. * Children may verbally identify the symbols or numbers, or trace symbols or numbers with a small paint brush or cotton swab, Pass/Fail - Standard Screening * Pass for Number Plates: Correctly identifying all the numbers on plates 1-8. * Fail for Number Plates: Not correctly identifying or seeing all the numbers on plates 1-8, * Pass for Pediatric Plates: Correctly identifying all symbols on plates 19-26. ** Fail for Pediatric Plates: Not correctly identifying or seeing all symbols on plates 19-26. Pass/Fail - Verification or Military and Government Requirements * Pass for Number Plates: Correctly identifying all the numbers on plates 1-15. * Fail for Number Plates: Not correctly identifying or seeing all the numbers on plates 1-15. Pass/Fail - Color Severity * Pass for Number Plates: Correctly identifying the number on plate 16. ‘Fail for Number Plates: Not correctly identifying or seeing the number on plate 16. Pass/Fail - Tritan (Blue/Yellow) * Pass for Number Plates: Correctly identifying all the numbers on plates 17-18. ‘* Fail for Number Plates: Not correctly identifying or seeing all the numbers on plates 17-18. Scoring * Understanding the Score Sheet table for the Older Child/Adult Numbers Section: = 1st column: Plate number. = 2nd column: Numbers a child/adult with normal color vision should identify. = 8rd column: What will ikely occur with a mild color vision deficiency. = 4th column: What will likely occur with a strong color vision deficiency. * Understanding the Score Sheet table for the Pediatric Symbols Section: = 1st column: Plate number. = 2nd column: Symbols a child with normal color vision should identify = 81d column: What will ikely occur if a color vision deficiency is present.Eats (en Mires Eamon 1 Demonstration Plate 35 35 35 2 9 Nothing Seen Nothing Seen 3 2 Nothing Seen Nothing Seen 4 73 28 of Nothing Seen Nothing Seen 5 Ey 81 oF Nothing Seen Nothing Seen 6 7 Nothing Seen Nothing Seen 7 92 Nothing Seen Nothing Seen 8 3% Nothing Seen Nothing Seen 9 87 Nothing Seen Nothing Seen 10 3 Nothing Seen Nothing Seen 1" 74. 21 oF Nothing Seen Nothing Seen 12 95, Nothing Seen Nothing Seen 8 5 3 or Nothing Seen Nothing Seen 14 4 Nothing Seen Nothing Seen 16 98 98 or Nothing Seén Nothing Seen 16 75 (715 Mild Defect 5 Severe Defect 17 - Titan (Blue/Yellow) 3 Nothing Seen Nothing Seen 18 - Titan (Blue/Yellow) 87 Nothing Seen Nothing Seen LEA Symbols Color Plates Geimces ren oes 19Demonstration Pate © O O O oon 0 20 oo a 24 oo oO 22 oo ao 23 oa ° 24 og Nothing Seen EJ oo Nothing Seen 26 og Nothing SeenJ!(et ee ee |Pediatric Pseudoisochromatic Color Vision Testing section using lea SY MBOLS* Hoan o S|OQUUAS SUIEIPSg \ColorCheck logo and all images from GolorCheck Testing are proprietary trademarks or copyrights of M&S Technologies, Inc., all rights reserved, and may not be disseminated, distributed, published, copied, or reproduced, in ‘whole or in part, without the prior written permission of M&S. TECHNOLOGIES INC 5715 W. Howard Street « Niles, IL 60714 ‘wwwimstech-eyes.cam