COSMIN database

Quality assessment of ophthalmic questionnaires: review and recommendations

Khadka, J., McAlinden, C., and Pesudovs, K.
PURPOSE: The aim of this article was to systematically review all the available ophthalmic patient-reported outcome (PRO) instruments (questionnaires) that demonstrated interval measurement properties to identify the instruments with the highest psychometric quality for use in different eye diseases and conditions.

METHODS: An extensive literature review was carried out to identify all existing ophthalmic PRO instruments. Instruments were then excluded if they did not have demonstrable interval measurement properties; the remaining instruments were reviewed. The quality of the following psychometric properties was assessed: content development (initial item development process), performance of the response scale, dimensionality (whether the instrument measures a single construct), measurement precision, validity (convergent, concurrent, discriminant, and known groups), reliability (test-retest), targeting (whether the items are appropriate [e.g., difficulty level] for the population), differential item functioning (whether subgroups of people respond differently to an item), and responsiveness.

RESULTS: The search identified 48 PRO instruments that demonstrated interval measurement properties, and these were relevant to nine applications: glaucoma, dry eye, refractive errors, cataract, amblyopia and strabismus, macular diseases, adult low vision, children low vision, and others. These instruments were evaluated against the psychometric property quality criteria and were rated for quality based on the number of criteria met.

CONCLUSIONS: This review provides a descriptive catalog of ophthalmic PRO instruments to inform researchers and clinicians on the choice of the highest-quality PRO instrument suitable for their purpose.
Optom Vis Sci
1538-9235 (Electronic)
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the eye and adnexa
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
ADVS - Activities of Daily Vision Scale
AI - Activity Inventory
AS-20 - Adult Strabismus Quality of Life questionnaire
ASQE (or A&SQ) - Amblyopia and Strabismus Questionnaire
Catquest (versions: Catquest-9SF)
CLIQ - Contact Lens Impact on Quality of Life
CSScale - Cataract Symptom Scale
CSScore - Cataract Symptom Score
CVAQC - Cardiff Visual Ability Questionnaire for Children
DLTV - Daily Living Tasks Dependent Upon Vision
GAL-10 - Glaucoma Activity Limitation (10 items)
GAL-9 - Glaucoma Activity Limitation (9 items)
GQL-15 (Also GQL-36 or GLAU-QOL36) - Glaucoma Quality of Life-15 (Glaucoma Quality of Life-36)
GSS - Glaucoma Symptom Scale
HVAT - Houston Vision Assessment Test
ICS - Impact of Cataract Surgery
IVI-C - Impact of Visual Impairment for Children
IVI - Impact of Vision Impairment
LFSES25 - Long Form Socio-Emotional Scale
LFSES39 - Long Form Socio-Emotional Scale
LFVFS25 - Long Form Visual Function Scale
LFVFS-39 - Long form visual functioning scale 39 items
LVP FVQ-II - Low Vision Prasad Functional Vision Questionnaire II
LVP FVQ - Low Vision Prasad Functional Vision Questionnaire
MacDQoL - Impact of Macular Disease on Quality of Life
McMonnies Questionnaire
Metamorphopsia Questionnaire
Mobility Questionnaire
NAVQ - Near Activity Visual Questionnaire (versions: NAVQ-10 items)
Near Vision Tasks
NEI RQL - National Eye Institute Refractive Error Correction quality of life Questionnaire (versions: NEI RQL-42 items)
NEI-VFQ-7 - 7-item National Eye Institute Visual Function Questionnaire
NEI VFQ - National Eye Institute Visual Function Questionaire (versions: NEI VFQ-9 items)
OCI - Ocular Comfort Index
OSDI - Ocular Surface Disease Index (and Modified OSDI; 10 item version)
QIRC - Quality of Life Impact of Refractive Correction Questionnaire
QoL-VFQ - Quality of life and visual function questionnaire
QoV - Quality of vision
RSVP - Refractive Status and Vision Profile
SFSES - Short Form Socio-emotional Scale
SFVFS - Short Form Visual Function Scale
TyPE Spec - Cataract TyPE Specification Questionnaire
VA LV VFQ - Veterans affairs low vision visual functioning questionnaire
VAQ - Visual Activities Questionnaire
VDA - Visual Disability Assessment
VF-11R - Long Form Visual Function
VF-14 - Visual Function Index-14 (versions: VF-7)
VF-8R - Short Form Visual Function
VFI - Visual Functioning Index
VF-QOL - Visual Function and Quality of Life