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If you are affected by color blindness or would like to learn more about it, we invite you to join the Avalanche Patient Voice Project by registering below. As a participant in this Project, you can be among the first to receive information about potential research study opportunities or therapies for color blindness.We realized that the study of this topic has become very relevant for many scientists, as we have recorded the growth of order term papers online on the topic of color blindness.
Your participation in this Project is voluntary. If you decide to enroll, you may discontinue participation at any time. You will not be charged for your participation in this registry, nor will you be paid or compensated in any way.
Any information published about the Project will be anonymous and written in such a way that you cannot be identified. Any information that identifies you will be kept confidential and will not be shared with anyone without your consent, including insurance companies and potential employers.
Participation is limited to residents of the United States.
* Yes, I understand the purpose of this survey.
Yes
No
Please answer the following questions. Thank you for adding your voice to the Project!
*1. Has a doctor ever told you that you are color vision deficient?
Yes
No
2. If you think you are color vision deficient, what colors do you have difficulty distinguishing?
Blue and purple
Brown and olive green
Orange and brown
Orange and olive green
Pink and gray
Other:
*3. Some patients are color vision deficient from birth, while others develop it over time as a result of other health problems or certain medications. To your knowledge, have you been color vision deficient since birth?
Yes
No
*4. Please check all of the following tests that you have had
Ishihara or HRR color plates (find the numbers, letters, or symbols inside circles that are made up of differently colored dots)
Lantern test
Color arrangement tests (Farnsworth D-15 or FM-100)
Anomaloscope
Genetic testing
None
I don't know
5. Please check the type of color vision deficiency that you suffer from:
Protanopia
Protanomaly
Deuteranopia
Deuteranomaly
Monochromatic
I am not sure or haven’t been diagnosed
6. When did you find out that you were color vision deficient for the first time?
Prior to elementary school
In elementary school
In middle or high school
In college or university
At work
Other:
* 7. Were you ever disqualified from a job based solely on the results of a color vision test?
Yes
No
8. In your own words, please describe the impact that color vision deficiency has had on your life:
9. What type of eye care provider have you seen most recently?
Optometrist
General ophthalmologist
Eye specialist (eg, retina specialist, glaucoma specialist)
I don’t know my eye care provider’s specialty
I cannot remember the last time I saw an eye care provider
10. Approximate month and year of most recent eye care provider appointment or check:
11. Do you have a colorblind relative in your immediate family?
Yes
No
12.If Yes, please choose all that apply:
Spouse
Mother
Father
Brother
Sister
Paternal grandparent
Maternal grandparent
Other:
13. Ethnicity
Hispanic or Latino
Not Hispanic or Latino
14. Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
15. What is the highest degree or level of school you have completed? If currently enrolled, indicate highest degree received.
Middle school or some high school, no diploma
Some college credit, no degree
Trade/technical/vocational training
Associate degree
Bachelor’s degree
Master’s degree
Professional degree
Doctorate degree
Yes, please include me on future communications and announcements from Avalanche Biotechnologies
Yes, I would like to be included on informational emails regarding clinical trial opportunities for color blindness.
Yes, I would like to create a password to be able to change my information later.
Please enter the following number in the text field to register.
Your password must be eight characters and contain at least one number, one lower case and one upper case letter.
Avalanche Biotechnologies does not sell, rent, or share information with any other organization. We do not transfer information for any promotional or marketing purposes, nor is that information shared with any third parties whatsoever. Our website contains links to other sites. We are not responsible for the privacy practices of these websites. Opt out of all emails or Delete Account or Resend Verification Email.