If you were born with color blindness, it will almost certainly stay the same throughout your life. Inherited color vision deficiency is stable, affects both eyes equally, and does not progress. But color vision that worsens over time is a real phenomenon, and it happens through a completely different pathway: acquired color vision loss, which can be caused by aging, disease, medications, or environmental exposures.
Why Inherited Color Blindness Stays Stable
Congenital color blindness is caused by missing or altered photoreceptors in your retina, the light-sensitive cells at the back of your eye. These cells are determined by your genetics before birth, and their function doesn’t change as you age. If you’ve had red-green color blindness your whole life, the severity you experience at 20 will be essentially the same at 70. This type accounts for the vast majority of color blindness cases, affecting roughly 8% of men and 0.5% of women.
How Aging Affects Color Perception
Even without any eye disease, your ability to distinguish colors declines as you get older. The lens of your eye gradually yellows over decades, and this yellowing disproportionately blocks short-wavelength (blue) light from reaching your retina. The result is a slow, subtle shift in how you perceive blues and purples. Most people don’t notice it because the change is so gradual.
Cataracts accelerate this process significantly. A cataract is a cloudy, often yellowish buildup in the lens that further reduces light transmission, with the greatest impact in the blue portion of the spectrum. People with cataracts frequently report that colors look duller or more washed out. The good news: cataract surgery replaces the clouded lens with a clear artificial one, and many patients are surprised by how vivid colors appear afterward. Blues, in particular, often look dramatically brighter than they remember.
Eye Diseases That Worsen Color Vision
Several common eye conditions can damage the structures responsible for color perception. Glaucoma gradually destroys nerve fibers that carry visual signals from your retina to your brain. Age-related macular degeneration breaks down the central part of your retina, where color-sensing cells are most concentrated. Both conditions can cause progressive color vision loss alongside their more well-known effects on sharpness and peripheral vision.
Diabetic eye disease is another major cause. Chronic high blood sugar damages the tiny blood vessels in the retina, and as the damage accumulates, color discrimination worsens. Sickle cell anemia and chronic alcoholism can also impair retinal blood flow and contribute to color vision decline over time.
Neurological Conditions and Color Loss
Your brain does just as much color processing as your eyes, so diseases affecting the nervous system can change how you see color. Multiple sclerosis is a particularly well-studied example. About 20% of MS patients first present with optic neuritis, an inflammation of the optic nerve. Even after visual sharpness recovers, many of these patients are left with lasting deficits in color perception. More recent research has shown that MS can damage retinal tissue even in patients who never experience a noticeable episode of optic neuritis, through a process where nerve degeneration spreads backward from damaged pathways in the brain.
Parkinson’s disease can impair blue-yellow color discrimination specifically, likely because of changes in how the brain processes signals from the most widely spaced color-sensing cells. Alzheimer’s disease also affects color vision as it damages visual processing areas. In all these conditions, color vision loss tends to worsen as the underlying disease progresses.
Traumatic brain injury is another route. A blow to the front of the head or face can cause indirect damage to the visual pathways at the back of the brain, resulting in decreased color vision along with other visual problems. Whether this improves depends on the severity and location of the injury.
Medications That Change Color Vision
A handful of commonly prescribed drugs are known to affect how you perceive color. Hydroxychloroquine, widely used for rheumatoid arthritis and lupus, can cause retinal toxicity that initially shows up as difficulty distinguishing blues and yellows. If the drug isn’t stopped, the damage can progress to affect red-green vision as well. This is why patients on long-term hydroxychloroquine typically undergo regular eye exams.
Ethambutol, a tuberculosis medication, can damage the optic nerve and cause blue-yellow color deficits. Digoxin, a heart medication, can temporarily alter red-green color perception by interfering with cellular activity in the retina. And sildenafil (commonly known as Viagra) can cause a temporary blue tint to vision by affecting the signaling process inside your color-sensing cells. The color changes from digoxin and sildenafil are typically reversible once the medication is stopped or the dose is adjusted, while hydroxychloroquine and ethambutol can cause lasting damage if caught too late.
Workplace Chemical Exposures
Chronic exposure to certain industrial chemicals can gradually erode color discrimination. Organic solvents are the biggest culprits. Workers with long-term exposure to styrene, carbon disulfide, perchloroethylene, and n-hexane have shown pronounced color vision impairment in studies. Mercury exposure, both organic and inorganic forms, has similar effects. These changes develop slowly with repeated exposure and may not be obvious until a formal color vision test reveals them, making routine screening important for workers in affected industries.
Can Acquired Color Vision Loss Be Reversed?
It depends entirely on the cause. Cataracts are the clearest success story: surgery restores the full spectrum of light reaching your retina, often dramatically improving color perception. Drug-induced color changes are frequently reversible if the medication is stopped early enough, before permanent structural damage occurs. Treating the underlying condition in diseases like diabetes or glaucoma can stabilize color vision and sometimes improve it, though damage already done to the retina or optic nerve is often permanent.
Color changes from neurodegenerative diseases like MS, Parkinson’s, or Alzheimer’s generally do not reverse, because they reflect progressive structural damage to the nervous system. The same is true for severe traumatic brain injuries. In these cases, the goal is slowing further decline rather than restoring what’s been lost.
How Color Vision Changes Are Tracked
If your doctor suspects your color vision is worsening, they may use specialized tests that go well beyond the basic dot-pattern screening most people remember from childhood. The Farnsworth-Munsell 100 Hue test, for example, asks you to arrange colored caps in order and generates a detailed error score that can pinpoint whether your deficit falls along the blue-yellow or red-green axis. This test is sensitive enough to detect subtle changes from medication side effects, early disease, or occupational exposures, and it can be repeated over time to track whether your color vision is stable or declining. Separate error scores for different color axes help clinicians distinguish between aging-related changes and damage from a specific disease or toxin.
One important distinction with acquired color vision loss: unlike inherited color blindness, it often affects one eye more than the other. If you notice that colors look different when you close one eye versus the other, that asymmetry is a meaningful clue that something beyond genetics is at play.