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The Development of the Chinese Intermittent Exotropia Questionnaire

Zhu, Hui*; Shen, Ling*; Yuan, Chao-Qun*; Xu, Shu; Leng, Zhen-Hua*; Fu, Zhu-Jun*; Xiao, Yun-Hua; Liu, Hu*

Optometry and Vision Science: June 2017 - Volume 94 - Issue 6 - p 707–713
doi: 10.1097/OPX.0000000000001080
Original Articles

Purpose The Intermittent Exotropia Questionnaire (IXTQ) is a child, proxy, and parent report of health-related quality of life specific to children with intermittent exotropia (IXT). The present study aimed to develop a Chinese-language version of the IXTQ (CIXTQ) and evaluate its validity and reliability when used in Chinese IXT children and their parents.

Methods The IXTQ was translated into Chinese. One hundred seventy-five IXT children (2 to 17 years old) and 151 orthotropic control children (2 to 17 years old) along with one of their parents were recruited. Children 5 to 17 years old completed the 5- to 7-year-old or the 8- to 17-year-old child questionnaire of the CIXTQ according to their age. Parents of all children (2 to 17 years old) completed the proxy and parent questionnaires of the CIXTQ. Psychometric properties of the CIXTQ were examined for floor and ceiling effects, construct validity, item-internal consistency, discriminative validity, Cronbach α coefficient and test-retest reliability.

Results No items were found to have strong floor or ceiling effects. Principal component analysis identified that the CIXTQ had a similar structure to the original English version. The median scores of each questionnaire in the CIXTQ among children with IXT and their parents were significantly lower than those among control subjects (P < .001). Cronbach α coefficients ranged from 0.869 to 0.931, and test-retest reliabilities ranged from 0.898 to 0.981, for each questionnaire in the CIXTQ.

Conclusions The CIXTQ is a useful tool to evaluate the influence of IXT on health-related quality of life among Chinese IXT children and their parents.




Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, China (HZ, Z-HL, Z-JF, HL); Nanjing Aier Eye Hospital, Nanjing, Jiangsu Province, China (LS); Nanjing BenQ Medical Center, Nanjing, Jiangsu Province, China (C-QY); and Nanjing Brain Hospital, Affiliated to Nanjing Medical University, Nanjing, Jiangsu Province, China (SX, Y-HX).

HZ and LS contributed equally to the study and are considered co–first authors.

Hu Liu, Department of Ophthalmology, The First Affiliated Hospital, with Nanjing Medical University, 300 Guangzhou Rd, Nanjing 210029 China, e-mail:

© 2017 American Academy of Optometry