1. DEVELOPING AND VALIDATION OF AN ARABIC VERSION OF THE VISUAL FUNCTIONING INDEX VF14 FOR CATARACT PATIENTS Abdulrahman Al-Muammar, MD, FRCSC King Abdul Aziz University Hospital College of Medicine King Saud University Mr Ahmed Mousa Dr Hatem Kalanton Dr Ali Alghamdi

2. RATIONALE The rationale for developing this index was the need for a tool that can accurately measure the outcome of cataract surgeries whereas visual acuity was found to be an incomplete measure to do that

3. It has been first developed by Earl P. Steinberg in the early nineties (Earl P. Steinberg et al (1994) The index has been widely accepted and utilized in different purposes including measuring the impact of ocular diseases on vision estimation of need for cataract surgery evaluation and comparison of different surgical techniques related to visual functioning cataract outcome assessment

4. THE VF 14 The index has been used to support research in: Glaucoma Retina Cornea Macular degeneration Low vision Prevention of blindness In different languages African region French German Chinese Italian Spanish

5. CATARACT AS A CAUSE OF LOW VISION AND BLINDNESS 52.2 million inhabitants are blind from cataract in the middle east region. WHO report (2004)

6. Due to the large number of Arabic speaking countries who are around 300,000,000 inhabitants and dramatic increase in ocular science research in the Arabic region, there is a tremendous need to develop and validate a reliable Arabic version of the VF 14 Due to the large number of Arabic speaking countries who are around 300,000,000 inhabitants and dramatic increase in ocular science research in the Arabic region, there is a tremendous need to develop and validate a reliable Arabic version of the VF 14

7. ESSENTIAL STEPS OF VALIDATION PROCESS

8. Methods The original VF 14 questionnaire was solely translated into Arabic language by two different ocular researchers The two version were matched and unified The new Arabic questionnaire was translated back to English by a third researcher (ophthalmologist) Native English speaker researcher was asked to match the original and the re-translated versions Minimal modifications took place by the research team to formulate a final version of the Arabic VF 14

10. Methods Cataract medical forms were filled by an ophthalmologist Snellen’s visual acuitySnellen’s visual acuity Global measure of visionGlobal measure of vision Cataract symptoms scoreCataract symptoms score The Arabic VF 14 questionnaire was done by an ophthalmic technician

11. Methods Scoring of the VF 14 index Global measure of vision Cataract symptoms score Testing validity using Pearson correlation test between the VF 14 and three international standardized tools: Global measure of vision Cataract symptoms score Snellen’s visual acuity LogMAR score Testing reliability using Cronbach’s Alpha test

12. RESULTS 1380 patients representing four hospitals; Two in Egypt Two in Saudi Arabia Mean (SD) age : 63.41 (11.19). 840 (60.9%) males 540 (39.1%) females Arabic VF Score: mean (SD) = 62.18 (19.34)

13. VALIDATION RESULTS Correlation with: Cataract Symptoms Score. p < 0.0001 Global measure of vision. Trouble index. p < 0.0001 Dissatisfaction index. p < 0.0001 Visual Acuity (LogMAR): p < 0.0001

14. RELIABILTY RESULTS Cronbach’s α test: α = 0.763, 95% CI: [0.743 – 0.782]. P value < 0.0001

15. MEASUREMENTS OF VF 14 INDEX AT LEVELS OF VISUAL ACUITY

16. CONCLUSION The Arabic VF 14 is a reliable and valid tool for evaluation of both visual functioning and quality of visual life among cataract patients who are being prepared for cataract surgery The VF 14 can be used in evaluating visual functioning as an outcome of surgical intervention either in cataract or in other ocular diseases It can be also used in decision making process for surgical interventions and for prioritization of surgical waiting lists Arabic VF 14 would facilitate comparing and contrast research results with similar results worldwide