Which color vision deficiencies would you MOST expect in optic nerve and macular disease, respectively?

In the context of optic nerve and macular diseases, the most expected color vision deficiencies are indeed red-green for optic nerve disease and blue-yellow for macular disease.

Optic nerve diseases, such as optic neuritis or glaucoma, typically affect the pathways responsible for color perception, particularly those associated with red and green wavelengths. This leads to red-green color deficiencies. The underlying reason is that the long (L) and medium (M) wavelength cones, which predominantly detect red and green colors respectively, are more susceptible to damage when the optic nerve is compromised.

Conversely, macular diseases, such as age-related macular degeneration, primarily involve dysfunction of the central retina where the concentration of cone photoreceptors, particularly the S-cones (short wavelengths responsible for blue detection), is critical for detailed color discrimination. These conditions can erode the ability to differentiate between blue and yellow colors, leading to a blue-yellow color vision deficiency.

Thus, the pairing of red-green deficiencies with optic nerve disease and blue-yellow deficiencies with macular disease reflects the underlying physiology of how these diseases impact color perception differently.