. 2020 May 5;37(6):2884–2901. doi: 10.1007/s12325-020-01275-4

Table 3.

Summary of key difficulties related to interpretation of the NEI VFQ-25 and the LLQ

Summary of issue	Number of items flagged as problematic in the NEI VFQ-25 and example	Number of items flagged as problematic in the LLQ and example
No specification of lighting conditions or familiarity of the environment	7/25 items were flagged Example: Because of your eyesight, how much difficulty do you have finding something on a crowded shelf? (Item 7) 9/21 participants reported that they would have difficulty selecting a response as their ability is affected by the lighting conditions	3/32 items were flagged Example: Do you have difficulty seeing when you visit other people’s homes because there is not enough light? (Item 19) 7/21 participants had difficulty interpreting the item stating that their visual ability is dependent on how familiar the environment is and lighting conditions in those environments
Some items provided multiple examples of activities which represented different levels of functional impairment	4/25 items were flagged Example: Because of your eyesight, how much difficulty do you have visiting with people in their homes, at parties or in restaurants? (Item 13) 8/21 participants reported that the examples included in the item would result in different responses	3/32 items were flagged Do you have difficulty seeing in poor lighting conditions such as at dusk or dawn or in a poorly lit room? (Item 16) 5/21 participants reported that there were differences in their visual ability in dusk, dawn and poorly lit rooms, making it difficult for them to decide how to respond
Response options stating ‘stopped doing this’ for specific activities were not always appropriate	8/25 items were flagged Example: Because of your eyesight, how much difficulty do you have noticing objects off to the side while you are walking along? (Item 10) 6/21 participants reported that they would never stop trying to notice objects off to the side	12/32 items were flagged Example: Do you have difficulty seeing colors at night? (Item 13) 4/21 participants reported that they would not stop trying to see color
Examples provided in the item were outdated	1/25 items were flagged Example: How much difficulty do you have doing work or hobbies that require you to see well up close, such as cooking, sewing, fixing things around the house or using hand tools? (Item 6) 3/21 participants suggested that more modern examples of tasks which require the ability to see up close should be used	1/32 items were flagged Example: Because of your vision, do you have difficulty going out to nighttime social events such as sporting events, the theater, friend’s homes, church or restaurants? (Item 10) 1/21 suggested that the examples should be modernized

Summary of issue

Number of items flagged as problematic in the NEI VFQ-25 and example

Number of items flagged as problematic in the LLQ and example

No specification of lighting conditions or familiarity of the environment

7/25 items were flagged

Example: Because of your eyesight, how much difficulty do you have finding something on a crowded shelf? (Item 7)

9/21 participants reported that they would have difficulty selecting a response as their ability is affected by the lighting conditions

3/32 items were flagged

Example: Do you have difficulty seeing when you visit other people’s homes because there is not enough light? (Item 19)

7/21 participants had difficulty interpreting the item stating that their visual ability is dependent on how familiar the environment is and lighting conditions in those environments

Some items provided multiple examples of activities which represented different levels of functional impairment

4/25 items were flagged

Example: Because of your eyesight, how much difficulty do you have visiting with people in their homes, at parties or in restaurants? (Item 13)

8/21 participants reported that the examples included in the item would result in different responses

3/32 items were flagged

Do you have difficulty seeing in poor lighting conditions such as at dusk or dawn or in a poorly lit room? (Item 16)

5/21 participants reported that there were differences in their visual ability in dusk, dawn and poorly lit rooms, making it difficult for them to decide how to respond

Response options stating ‘stopped doing this’ for specific activities were not always appropriate

8/25 items were flagged

Example: Because of your eyesight, how much difficulty do you have noticing objects off to the side while you are walking along? (Item 10)

6/21 participants reported that they would never stop trying to notice objects off to the side

12/32 items were flagged

Example: Do you have difficulty seeing colors at night? (Item 13)

4/21 participants reported that they would not stop trying to see color

Examples provided in the item were outdated

1/25 items were flagged

Example: How much difficulty do you have doing work or hobbies that require you to see well up close, such as cooking, sewing, fixing things around the house or using hand tools? (Item 6)

3/21 participants suggested that more modern examples of tasks which require the ability to see up close should be used

1/32 items were flagged

Example: Because of your vision, do you have difficulty going out to nighttime social events such as sporting events, the theater, friend’s homes, church or restaurants? (Item 10)

1/21 suggested that the examples should be modernized