Validation of the Visual Disability Questionnaire (VDQ) in India


Purpose: To validate visual disability questionnaire (VDQ) in patients with low vision in India, and explore whether the two latent traits “importance” and “difficulty” associated with performance of daily activities are valid and independent constructs.

Methods: The VDQ consisting of 25 items was administered verbally to 137 subjects with low vision aged 16 to 89 years. Responses for each item were rated for importance and difficulty using a 5-category Likert scale. Rasch analysis was used to estimate interval measures of response ratings.

Results: Subjects could discriminate only three response categories for importance and difficulty. Content validity was demonstrated by good separation indices for importance (4.24 and 2.59 for the item and person parameters, respectively) and difficulty ratings (7.64 and 3.33, respectively). High reliability scores were recorded for importance (0.95 and 0.87) and difficulty ratings (0.98 and 0.92). The most important items were “grooming” (1.15 logits) and “reading newspaper” (0.97 logits). Although “threading a needle” was the least important item (–2.79 logits), it was the most difficult task (3.13 logits). The least difficult item was moving around in familiar places (–2.51 logits). A poor correlation was observed between the item measures (r= –0.19, p = 0.34) and also between person measures (r = 0.18, p = 0.03) of importance and difficulty.

Conclusions: The VDQ is a valid questionnaire with importance and difficulty ratings found to be independent constructs. This questionnaire could be used to prioritize the goals for rehabilitation intervention in patients with low vision.

Key words: visual impairment, low vision, daily activities, importance, difficulty and Rasch analysis.

Optom Vis Sci 2009;86:E826–E835.
Accepted for publication December 10, 2008.

Manjula Marella BSOptom, Vijaya K. Gothwal MAppSc, PhD, Konrad Pesudovs PhD, FAAO, and Ecosse Lamoureux MSc, PhD
Meera and L. B. Deshpande Centre for Sight Enhancement, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India (MM, VKG),
Department of Ophthamology, Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of Melbourne, Victoria, Australia (MM, EL),
NHMRC Centre for Clinical Eye Research, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia (KP, VKG), and
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore (EL).


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