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Validation of an instrument to assess visual ability in children with visual impairment in China
  1. Jinhai Huang1,2,
  2. Jyoti Khadka1,3,
  3. Rongrong Gao1,
  4. Sifang Zhang1,
  5. Wenpeng Dong1,
  6. Fangjun Bao1,
  7. Haisi Chen1,
  8. Qinmei Wang1,2,
  9. Hao Chen1,2,
  10. Konrad Pesudovs3
  1. 1School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
  3. 3Discipline of Optometry, Flinders University of South Australia, Adelaide, South Australia, Australia
  1. Correspondence to Dr Hao Chen, Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China; chenhao{at} and Dr Qinmei Wang; wqm6{at}


Objective To validate a visual ability instrument for school-aged children with visual impairment in China by translating, culturally adopting and Rasch scaling the Cardiff Visual Ability Questionnaire for Children (CVAQC).

Methods The 25-item CVAQC was translated into Mandarin using a standard protocol. The translated version (CVAQC-CN) was subjected to cognitive testing to ensure a proper cultural adaptation of its content. Then, the CVAQC-CN was interviewer-administered to 114 school-aged children and young people with visual impairment. Rasch analysis was carried out to assess its psychometric properties. The correlation between the CVAQC-CN visual ability scores and clinical measure of vision (visual acuity; VA and contrast sensitivity, CS) were assessed using Spearman's r.

Results Based on cultural adaptation exercise, cognitive testing, missing data and Rasch metrics-based iterative item removal, three items were removed from the original 25. The 22-item CVAQC-CN demonstrated excellent measurement precision (person separation index, 3.08), content validity (item separation, 10.09) and item reliability (0.99). Moreover, the CVAQC-CN was unidimensional and had no item bias. The person–item map indicated good targeting of item difficulty to person ability. The CVAQC-CN had moderate correlations between CS (−0.53, p<0.00001) and VA (0.726, p<0.00001), respectively, indicating its validity.

Conclusions The 22-item CVAQC-CN is a psychometrically robust and valid instrument to measure visual ability in children with visual impairment in China. The instrument can be used as a clinical and research outcome measure to assess the change in visual ability after low vision rehabilitation intervention.

  • Low vision aid
  • Child health (paediatrics)
  • Vision

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