Italian translation and validation of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8)


Purpose To translate and validate an Italian version of the CLDEQ-8 (CLDEQ-8_IT). Methods The study was carried out in two phases. In the first phase, a cross-cultural adaptation of CLDEQ-8 to Italian was performed by forward and backward translation in sequence. In the second phase, a multi-centre study was conducted for the validation of the questionnaire. Validity CLDEQ-8_IT was evaluated against three gestalt questions: overall opinion of soft contact lenses (CLs), global self-assessments of eye sensitivity and eye dryness. Reliability was evaluated by test–retest assessment in a subgroup of subjects. Finally, the psychometric properties of CLDEQ-8_IT were explored by Rasch analysis. Results Two hundred and forty soft CL wearers, fluent Italian speakers (73 males and 167 females), between 18 and 70 years of age were enrolled. A significant correlation was found between CLDEQ-8_IT and each of the three Gestalt questions. The cutoff score of 12 points demonstrated the best balance between sensitivity and specificity in differentiating wearers grading their CLs as “Excellent/Very good” from those reporting their overall opinion as “Good/Fair/Poor”. The Intraclass Correlation Coefficient between test and retest was 0.88 (95% CI: 0.81–0.92). Finally, infit and outfit statistics using Rasch analysis for the 8 items were in a good range, however Principal Components Analysis revealed a certain degree of multi-dimensionality of the instrument. Also, item 8 analysis could be computed after merging the last two response categories. Conclusion The CLDEQ-8_IT showed very good validity and reliability in measuring symptoms of CL wearers, comparable to the original English language version. A cut-off of 12 was confirmed as yielding the best balance between sensitivity and specificity in detecting CL wearers who could benefit from clinical management of their CL-related symptoms. Collapsing of the response options 5 and 6 in the last item of questionnaire could optimise its functioning.

Publication DOI:
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
Aston University (General)
Additional Information: Copyright © 2023 British Contact Lens Association. Published by Elsevier Ltd. This accepted manuscript version is licensed under under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Uncontrolled Keywords: contact lens discomfort,questionnaire,CLDEQ-8_IT,symptoms
Publication ISSN: 1476-5411
Full Text Link:
Related URLs: https://www.sci ... 367048423000462 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2023-06
Published Online Date: 2023-04-04
Accepted Date: 2023-03-31
Authors: Zeri, Fabrizio (ORCID Profile 0000-0003-0529-555X)
Tavazzi, Silvia
Naroo, Shehzad A. (ORCID Profile 0000-0002-6373-7187)
Recchioni, Alberto
Menduni, Francesco
Ponzini, Erika
Chalmers, Robin
Desiato, Alfredo



Version: Accepted Version

Access Restriction: Restricted to Repository staff only until 4 April 2024.

License: Creative Commons Attribution Non-commercial No Derivatives

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