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Pediatric Surveys

The contents of this section have been gathered to offer the clinician various patient symptom surveys to better understand the patient’s symptoms.  The surveys focus on either visual skills, self-awareness or quality of life. Each of the surveys included have been validated and are readily available to be downloaded and used.  Each survey will be presented as a pdf or we have provided links for the surveys.

If you have another survey that is validated that you would like to share with members of the WCO, please forward it to the World Council of Optometry office to the attention of the Chair of the Public Health Committee.

Quality of Life and Vision Symptom Surveys


Pediatric Eye Disease Investigator Group (PEDIG)

This website includes a PEDEyeQ resource for children 0-4, 5-11, and 12-17 years old. These surveys are more detailed and aimed at researchers. Includes Spanish versions.

Children Ages 0-4 Years

  • Instructions for clinicians/researchers
  • PedEyeQ Ages 0-4 Years
  • Spanish PedEyeQ Ages 0-4
  • Rasch Lookup Table: Proxy 0-4 Years
  • Rasch Lookup Table: Parent

Children Ages 5-11 Years

  • Instructions for clinicians/researchers
  • PedEyeQ Ages 5-11 Years
  • Spanish PedEyeQ Ages 5-11
  • Rasch Lookup Table: Proxy 5-11 Years
  • Rasch Lookup Table: Parent

Children Ages 12-17 Years

  • Instructions for clinicians/researchers
  • PedEyeQ Ages 12-17 Years
  • Spanish PedEyeQ Ages 12-17
  • Rasch Lookup Table: Proxy 12-17 Years
  • Rasch Lookup Table: Parent

College of Optometrists in Vision Development Quality of Life Checklist

To download, click here.

 


Convergence Insufficiency Symptom Survey

To download, click here.