It’s not easy seeing green

The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.

The great poet philosopher Kermit the Frog once said, “It’s not easy being green.”

I recalled that pearl as my wife and I watched the Broadway play Wicked on a recent vacation to New York City. Not only that, I thought at the time, but for some of us, it’s not easy seeing green either!

I knew that one of the main characters, Elphaba, was supposed to be green, but to me her face was a dullish gray. Maybe it was because we were sitting up high in the so-called “cheap” seats and wavelengths of about 510 nanometers ran out of gas before reaching us.

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For a fleeting second I even thought about marching to the box office to demand a refund for false representation of pigmentation. But I knew the truth lay deep inside my hopelessly flawed retinas: I am (gasp!) an anomalous trichromat.

Then the memories started, a steady stream of hue howlers that even in the darkened theater caused my face to burn a shade of hot pink-or something like that.

Do I not know my colors?

It began when my mother started allowing me to dress myself, and I would emerge from my room wearing a green sock on one foot and a gray one on the other.

Unaware that my chromatic cluelessness was all her fault, she assumed that I simply hadn’t learned my colors well enough. So she bought me one of those Crayola boxes of “64 Different Brilliant Colors” with the built-in sharpener, tossed me a stack of coloring books, and told me to get busy and stop bothering her, for Pete’s sake.

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When I opened it up, I saw 64 crayons but about only 32 different colors and figured it must be a factory error. Oh well, no problem. It was the late 1960s, and back then you could slap on any old color or pattern combination, and you were groovy and good to go.

But by 1980, alarm bells sounded, and sorta red warning lights flashed when I enrolled in inorganic chemistry. I was convinced that my entire future probably rested on my ability to titrate, so I painstakingly tried to add just enough solution into my Erlenmeyer flask to reach the endpoint’s expected color.

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With blue endpoints I had no problems, but if the solution was supposed to turn “just pink,” I always ended up in “obviously red.” I blamed it on a long, unlucky string of faulty stopcocks, but my professor shook his head, probably thinking to himself: That guy is never going anywhere near a patient.

We have a hit!

It all came to a head in optometry school when what I had always thought of as my very original, quirky take on the color palette was suddenly outed and labeled as “abnormal.” It was color vision lab, and when I couldn’t see those stupid, dot-numbers that were supposedly embedded in all those other stupid dots (I mean, really, come on), my professor exclaimed, “We have a hit!”

The second floor of the UAB Optometry School building shook from the herd of pathology-starved, second-year optometry students who stampeded into the tiny exam nook to watch me stammer and sweat my way through that way overrated, so-called “test.” In a panic, I just started picking random numbers, like I was filling out a lottery ticket. Some of my classmates shook their heads sadly, while others stifled laughs. I knew I could see colors, so I didn’t understand all the commotion.

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But on the upside, at least I now knew what I was dealing with and proceeded to adjust. I learned that my red-green weakness makes it more difficult for me to sort out light-gray choroidal nevi from reddish-orange retinal pigment, especially with the bright lights of indirect ophthalmoscopy. The perspective and less intense brightness of traditional fundus photography helped by increasing contrast, and the broader field of view and digital filters of modern ultra-widefield imaging (UWF) helped even more.

Of course, whenever I personally test a patient with pseudoisochromatic plates, I have to use one hand to hold the test booklet and flip the pages and the other to hold the little table containing the correct answers. I was testing a young boy one time and his mother spotted me eyeing my “cheat sheet.” She gave me a little grin and wink, as if to say: Don’t worry, your secret’s safe with me.

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I’ve spent my professional life trying to explain to others how we color-deficients aren’t truly “color blind.” I don’t even like the word “deficient.” I prefer to believe that we are more efficient in our color perception, bundling together large, unwieldy numbers of various wavelengths into smaller, neater packages of photons, a point that was completely lost on the cop who pulled me over that time for running a traffic light.

Being green

Back in New York, Elphaba embraced her true identity and started proudly flying her emerald freak flag in Act 1’s closing number, “Defying Gravity.” The stage was saturated with enough mid-range visible wavelengths of light that even my tired, old chromatically-challenged cones finally fired a clear, unmistakable burst of green.

The moral of the musical is that life is not always black and white but sometimes many shades of gray. Yeah, tell me something I didn’t already know.

 Read more from Dr. Brown here