Amblyopia & Strabismus Questionnaire: design and initial validation

Abstract

Literature on the benefits of screening and treatment of amblyopia emphasizes the costs of insufficiently treated amblyopic patients who lose their better eye. However, patients with insufficiently treated amblyopia and strabismus who do not lose their better eye only experience a slight decrease in their quality of life, and such patients occur more frequently. We designed and validated a questionnaire for amblyopia and strabismus in order to assess the decrease in quality of life of such patients. Complaints were collected from outpatients and reduced to five domains, pertaining to distance estimation, visual disorientation, problems with social contacts and cosmetic problems, diplopia, and fear of losing the better eye. For these domains 26 questions were formulated that constitute the Amblyopia & Strabismus Questionnaire (A&SQ). The A&SQ, the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) and the Short Form-12 Health Survey (SF-12) were presented to 53 healthy controls, 68 outpatients and a cohort of 174 outpatients born between 1962 and 1972 and treated between 1968 and 1974 for amblyopia and strabismus. The quality of life was best in healthy controls and worst in current outpatients, not only on the SF-12 and the VFQ-25 but also on the A&SQ, demonstrating an acceptable construct validity of the A&SQ. The decrease in the quality of life as measured by the A&SQ was most outspoken in our outpatient group of amblyopia and strabismus patients, less in the cohort that had been treated 30 years previously and least in the healthy controls, demonstrating an acceptable discriminatory validity of the A&SQ.

Amblyopia and Strabismus Questionnaire (A&SQ): clinical validation in a historic cohort

“…For 36 patients, the given phone numbers were not longer in service. Of the traced 203 patients, 174 filled out and returned the SF-12, the VFQ-25, and the A&SQ [5], whereas the questionnaires for four patients were sent to an old address.…”

“…We have therefore designed a questionnaire-analogous to the National Eye Institute Visual Function Questionnaire-25 [3] (VFQ-25) [4]-specific for amblyopia and strabismus in order to assess the decrease in quality of life of such patients, the Amblyopia and Strabismus Questionnaire (A&SQ) [5]. The A&SQ is similar to the VFQ-25 in design, format and methods of development and of scoring.…”

“…The A&SQ has been translated into English [6]. Content validity and criterion validity have been previously evaluated by comparison with two existing and validated quality of life questionnaires, the VFQ-25 and the Short-Form 12 Health Survey (SF-12) [5]. In that study, 53 healthy controls, 68 outpatients and a historic cohort of 174 patients had filled out the questionnaires.…”

Quality of Life of Adults Before and After Strabismus Surgery at a Tertiary Care Eye Centre of Kathmandu, Nepal

“…9,10,11,12,13,14,15,16 In a comparative study on quality of life of strabismic and non-strabiscmic visually normal adults, there was statistically significant difference in the overall score, psychosocial score as well as function score (p value 0.00). 17 Improvement in ocular alignment and restoration of sensory status occurs after surgical treatment of adult strabismus.…”

“…26,27,28,29,30 Up to 75% of patients who had strabismus from childhood also demonstrated some degree of fusion after realignment. 31,32 Patient oriented outcome in medical care is characterized by the quantification of changes in the health related quality of life following treatment. 32 Strabismus with impairment in visual function and psychosocial function has been identified in recent years and tools like Amblyopia and Strabismus Questionnaire 33 and 20 item Adult Strabismus Quality of life questionnaire 34 have been developed.…”