title: Development of a quality-of-life questionnaire for adults with strabismus.
abstract: OBJECTIVE
  We report the development of a patient-derived, health-related quality-of-life (HRQOL) questionnaire for adults with strabismus.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Twenty-nine patients with strabismus in a first phase, and 32 patients with strabismus, 18 patients with other eye diseases, and 13 visually normal adults in a second phase.
  
  
  METHODS
  Individual patient interviews generated 181 questionnaire items. For item reduction, we asked 29 patients with strabismus to complete the 181-item questionnaire, analyzed responses, and performed factor analysis. Two prominent factors were identified, and the 10 items with the highest correlation with each factor were selected. The final 20-item questionnaire (10 psychosocial items and 10 function items) was administered to an additional 32 patients with strabismus (22 with diplopia, 10 without diplopia), 13 visually normal adults, and 18 patients with other eye diseases. A 5-point Likert-type scale was used for responses (never = 100, rarely = 75, sometimes = 50, often = 25, and always = 0). Median overall questionnaire scores and psychosocial and function subscale scores, ranging from 0 (worst HRQOL) to 100 (best HRQOL), were compared across groups.
  
  
  METHODS
  The HRQOL questionnaire response scores.
  
  
  RESULTS
  Median overall scores were statistically significantly lower (worse quality of life) for patients with strabismus (56) compared with visually normal adults (95; P<0.001) and patients with other eye diseases (86; P<0.001). Median scores on the psychosocial subscale were significantly lower for strabismus patients (69) compared with visually normal adults (99; P<0.001) and patients with other eye diseases (94; P<0.001). For the function subscale, median scores were again significantly lower for strabismus patients (43) compared with visually normal adults (91; P<0.001) and patients with other eye diseases (78; P<0.001).
  
  
  CONCLUSIONS
  We have developed a 20-item, patient-derived, HRQOL questionnaire specific for adults with strabismus, with subscales to assess psychosocial and function concerns. This 20-item, condition-specific questionnaire will be useful for assessing HRQOL in individual strabismus patients and also as an outcome measure for clinical trials.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Hatt
authors.forename: David A
authors.initials: DA
authors.lastname: Leske
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bradley
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Holmes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004172:Diplopia / Q000523:psychology; D005260:Female; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013285:Strabismus / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States