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There is a need for a straightforward, accessible and accurate pediatric test for color vision deficiency (CVD). We present and evaluate  ColourSpot,  a self-administered, gamified and color calibrated tablet-based app, which diagnoses CVD from age 4. Children tap colored targets with saturations that are altered adaptively along the three dichromatic confusion lines. Two cohorts (Total,  N  = 772; Discovery,  N  = 236; Validation,  N  = 536) of 4–7-year-old boys were screened using the Ishihara test for Unlettered Persons and the Neitz Test of Color Vision.  ColourSpot  was evaluated by testing any child who made an error on the Ishihara Unlettered test alongside a randomly selected control group who made no errors. Psychometric functions were fit to the data and “threshold ratios” were calculated as the ratio of tritan to protan or deutan thresholds. Based on the threshold ratios derived using an optimal fitting procedure that best categorized children in the discovery cohort,  ColourSpot  showed a sensitivity of 1.00 and a specificity of 0.97 for classifying CVD against the Ishihara Unlettered in the independent validation cohort.  ColourSpot  was also able to categorize individuals with ambiguous results on the Ishihara Unlettered. Compared to the Ishihara Unlettered, the Neitz Test generated an unacceptably high level of false positives.  ColourSpot  is an accurate test for CVD, which could be used by anyone to diagnose CVD in children from the start of their education.  ColourSpot  could also have a wider impact: its interface could be adapted for measuring other aspects of children’s visual performance.

ColourSpot, a novel gamified tablet-based test for accurate diagnosis of color vision deficiency in young children