The College of Optometrists in Vision Development checklist related to vision function: expert opinions

The College of Optometrists in Vision Development (COVD) Quality of Life (QOL) checklist has been reported to have good test-retest reliability. Symptom scores measured by this instrument have demonstrated validity by showing a significantly improved score with optometric vision therapy. The COVD-QOL scores inversely correlate with academic achievement on standardized tests, and the instrument has been shown to differentiate between attention deficit disorder/attention deficit hyperactivity disorder children. The individual items on the COVD-QOL have not, however, been studied as to their relationship to general areas of vision investigated by the optometric examination.

To ascertain if COVD-QOL symptoms can be related to areas of vision function, a group of 28 practicing optometrists from all parts of the United States were surveyed for their opinions. The venue was a conference whose theme was vision therapy and the functional use of lenses and prisms. All the participants offered vision therapy within their practices. They were asked to rank 5 general areas of vision skills (orientation, ocular motor, binocular, accommodation, and perception) as to whether these areas might relate to individual symptoms contained in the COVD-QOL. A frequency distribution was developed based on these results. A Likert scale was also used to compare the specific symptom (COVD-QOL item) to the opinion of the clinicians who participated. A Likert scale assumes equal separation among the 5 levels of symptom severity.

Thirteen items were found to have high agreement, and 11 were considered in moderate agreement when the opinions of these experts were compared. Each of the 5 areas of vision had at least 1 item with high or moderate agreement.

Expert opinion is a reasonable first step in investigating symptoms as they relate to signs, but more study is needed to verify if these subjective relationships actually exist.