CVS-Q teen: an adapted, reliable and validated tool to assess computer vision syndrome in adolescents

Adolescents' extensive use of digital devices raises significant concerns about their visual health. This study aimed to adapt and validate the computer vision syndrome questionnaire (CVS-Q^©) for adolescents aged 12-17 years. A mixed-method sequential design was used. First, a qualitative study was involved two nominal groups to assess the instrument's acceptability. A subsequent cross-sectional quantitative study with 277 randomly selected adolescents assessed reliability and validity. Participants completed the adapted CVS-Q^©, an ad hoc questionnaire, and the ocular surface disease index (OSDI) questionnaire. Repeatability was tested in 54 adolescents after 7-14 days. The Rasch-Andrich rating scale model was used. Instructions and symptoms were modified to obtain the 14-item CVS-Q teen^©. It showed unidimensionality, no local dependence between items, and respected monotonicity. Adequate internal consistency (person reliability = 0.69, item reliability = 0.98) and intraobserver reliability (intraclass correlation coefficient = 0.77, Cohen's Kappa = 0.49) were observed. A significant correlation (0.782, p < 0.001) between CVS-Q teen^© and OSDI supported construct validity. A score of ≥ 6 points indicated computer vision syndrome (CVS) (sensitivity = 85.2%, specificity = 76.5%, and area under the curve = 0.879). In conclusion, CVS-Q teen^© is a valid and reliable instrument for assessing CVS in adolescents using digital devices, applicable in research and clinical practice for early identification and recommendations for visual health.