Validation of the Pediatric Eye Questionnaire in Children with Visual Impairment

Abstract

Purpose: To evaluate the recently developed Pediatric Eye Questionnaire (PedEyeQ) in visually impaired and visually normal children, as an initial validation of the PedEyeQ.

Design: Questionnaire validation study.

Methods: A total of 48 children with visual impairment (retinal, cortical, and corneal conditions) and 59 visually normal controls were enrolled at 2 centers. Five- to 17-year-old children completed the Child PedEyeQ (5-11- and 12-17-year-old versions), and parents completed the Proxy PedEyeQ (0-4-, 5-11-, and 12-17-year-old versions) and the Parent PedEyeQ. Rasch scores were calculated by age group for each distinct domain within each age-specific PedEyeQ (converted to 0-100 for interpretation). Domains for the Child PedEyeQ are functional vision, bothered by eyes/vision, social, and frustration/worry. Proxy PedEyeQ domains are functional vision, bothered by eyes/vision, social, frustration/worry, and eye care. Parent PedEyeQ domains are impact on parent and family, worry about child's eye condition, worry about child's self-perception/interactions, and worry about child's functional vision. For each domain, median PedEyeQ scores were compared between visually impaired and visually normal cohorts.

Results: Child 5-11 and 12-17 PedEyeQ scores were significantly lower (worse) for visually impaired children than for controls for each domain (P < .007), except for the social domain in 5-11-year-old children (P = .13). In addition, Proxy 0-4-, 5-11-, and 12-17-year-old PedEyeQ scores, and Parent PedEyeQ scores, were lower for visually impaired children across all domains (P < .001).

Conclusions: Visually impaired children and their parents had significantly lower (worse) PedEyeQ scores than visually normal controls, across functional vision and eye-related quality of life domains, demonstrating known-group validity of the PedEyeQ in children with visual impairment.

Figure 1:

Child 5–11 year old PedEyeQ domain scores (Functional Vision, Bothered by Eyes and Vision, Social, and Frustration / Worry) in visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for visually impaired children (P<.007) for all domains except Social (P=.13). Mean differences (with 95% confidence intervals) between visually impaired and visually normal children were: Functional Vision −27 (−39, −15), Bothered by Eyes and Vision −24 (−40, −9), Social −10 (−25, 4), and Frustration / Worry −15 (−31, −1).

Figure 2:

Child 12–17 year old PedEyeQ domain scores (Functional Vision, Bothered by Eyes and Vision, Social, and Frustration / Worry) in visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for visually impaired children across all domains (P<.001). Mean differences (with 95% confidence intervals) between visually impaired and visually normal children were: Functional Vision −46 (−63, −29), Bothered by Eyes and Vision −35 (−66, −5), Social −38 (−71, −6), and Frustration / Worry − 41 (−61, −20).

Figure 3:

Proxy 0–4 year old PedEyeQ domain scores (Functional Vision, Bothered by Eyes and Vision, and Social) in visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for visually impaired children across all domains (P<.001). Mean differences (with 95% confidence intervals) between visually impaired and visually normal children were: Functional Vision −51 (−66, −37), Bothered by Eyes and Vision −34 (−48, −19), and Social −17 (−29, −6).

Figure 4:

Proxy 5–11 year old PedEyeQ domain scores (Functional Vision, Bothered by Eyes and Vision, Social, Frustration / Worry and Eye Care) in visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for visually impaired children across all domains (P<.001). Mean differences (with 95% confidence intervals) between visually impaired and visually normal children were: Functional Vision −64 (−79, −50), Bothered by Eyes and Vision −38 (−53, −38), Social −19 (−29, −10), Frustration / Worry −26 (−41, −26) and Eye Care −21 (−32, −10).

Figure 5:

Proxy 12–17 year old PedEyeQ domain scores (Functional Vision, Bothered by Eyes and Vision, Social, Frustration / Worry and Eye Care) in visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for visually impaired children across all domains (P<.001). Mean differences (with 95% confidence intervals) between visually impaired and visually normal children were: Functional Vision −68 (−89, −47), Bothered by Eyes and Vision −46 (−65, −27), Social −48 (−75, −20), Frustration / Worry −38 (−65, −12) and Eye Care −29 (−49, −9).

Figure 6:

Parent PedEyeQ domain scores (Impact on Parent / Family, Worry regarding Child’s Eye Condition, Worry regarding Child’s Self-perception / Interactions, and Worry regarding Child’s Visual Function) in parents of visually impaired and visually normal children. Boxes represent 1^st quartile, median and 3^rd quartile values; whiskers represent extreme values. Scores were significantly lower for parents of visually impaired children across all domains (P<.001). Mean differences (with 95% confidence intervals) between parents of visually impaired and parents of visually normal children were: Impact on Parent / Family −38 (−45, −31), Worry regarding Child’s Eye Condition − 58 (−66, −50), Worry regarding Child’s Self-perception / Interactions −48 (−57, −40) and Worry regarding Child’s Visual Function −58 (−67, −50).