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G.W. Van der Sterre, E.S. van de Graaf, B. Simonsz, H. van Kempen, H.J. Simonsz; The Waterland Study: Clinical Validation of the Amblyopia & Strabismus Questionnaire (A&SQ;) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2564.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Existing questionnaires that measure vision–related quality of life disregard problems caused by amblyopia and strabismus. We developed the A&SQ to measure quality of life in such patients and tested its clinical validity. Methods:Complaints were collected from amblyopia and strabismus outpatients and grouped into six domains: 1) fear of loosing the better eye, 2) lack of depth vision, 3) visual disorientation, 4) double vision, 5) social contact and 6) cosmetic. For each domain questions were formulated. The questionnaire was presented to patients with varying degree of amblyopia, strabismus, systemic co–morbidity and social background. Questions considered difficult, confusing or repetitive were omitted. Only questions answered by more than 80% of the patients were included. The A&SQ was presented together with the VFQ–25 and the SF–12 to 50 healthy controls, 60 outpatients with amblyopia or strabismus and 174 out of 470 patients born between 1962–1972 and patched for amblyopia in Waterland between 1968–1974. Re–examination of 137 of these allowed clinical validation of the A&SQ. Results:For discriminant validity, A&SQ scores were compared between controls, the Waterland group and outpatients. For construct validity, A&SQ scores were compared with SF–12, and VFQ–25 scores. Both showed acceptable correlations. For clinical validity it was found that fear of loosing the better eye, lack of depth vision and visual disorientation correlated most strongly with current distance and reading acuity of the amblyopic eye. Lack of depth vision and visual disorientation also correlated with current level of stereoacuity and eccentric fixation. Social contact and cosmetic problems correlated with manifest angle of strabismus, latent nystagmus, DVD and current level of stereoacuity. Norm scores for each domain of the A&SQ were assessed. Conclusions: The A&SQ is effective in assessing the quality of life in amblyopia and strabismus patients. Current distance and reading acuity of the amblyopic eye are predominant determinants.
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