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. Author manuscript; available in PMC: 2015 Aug 1.
Published in final edited form as: Optom Vis Sci. 2014 Aug;91(8):1000–1011. doi: 10.1097/OPX.0000000000000314

Appendix.

Questions and Response Options on the Questionnaire

Item # Category Question Response Options
1 2 3 4 5 6 7
1 Opinion I believe that maintaining eye contact is important for social communication Definitely true Mostly true Somewhat true Somewhat false Mostly false Definitely false -
2 Opinion I look people in the eye and maintain eye contact when speaking with them Definitely true Mostly true Somewhat true Somewhat false Mostly false Definitely false -
3 Opinion My eyesight has no impact on my ability to communicate with others Definitely true Mostly true Somewhat true Somewhat false Mostly false Definitely false -
4 Social interaction difficulties Because of your eyesight, how much difficulty do you have in knowing whether a person is looking at you during social interactions (e.g., conversations) No difficulty A little difficulty Some difficulty Moderate difficulty Extreme difficulty Stopped doing this because of your eyesight Stopped doing this for other reasons or not interested in doing this
5 Social interaction difficulties Because of your eyesight, how much difficulty do you have in knowing whether a person is looking at somebody else during social interactions (e.g., conversations) No difficulty A little difficulty Some difficulty Moderate difficulty Extreme difficulty Stopped doing this because of your eyesight Stopped doing this for other reasons or not interested in doing this
6 Social interaction difficulties Because of your eyesight, how much difficulty do you have seeing how people react to things you say? No difficulty A little difficulty Some difficulty Moderate difficulty Extreme difficulty Stopped doing this because of your eyesight Stopped doing this for other reasons or not interested in doing this