Translation and Preliminary Psychometric Evaluation of the Arabic 5-Item Dry Eye Questionnaire: A Reliability Study in Healthy Young Adults

Haya Al Farhan, Sarah A Aldawasri, Abrar M Al Salloum, Naeema S Anazi, Hani Alarify, Wafa Majed Al-Otaibi Optometry Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Haya Al Farhan, Optometry Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, Tel +96652103321, Email halfarhan@ksu.edu.saPurpose: To translate the 5-Item Dry Eye Questionnaire (DEQ-5) into Arabic and conduct a preliminary psychometric evaluation of its reliability and internal consistency for DED symptom screening in Arabic-speaking populations.Methods: Two native Arabic translators initially translated the DEQ-5 from English into Arabic. An interdisciplinary committee developed a unified consensus version, subsequently back-translated by two native English speakers. The finalized questionnaire was administered to 60 healthy Arabic-speaking volunteers (aged 18– 40 years) by two independent observers at two sessions spaced 2– 5 days apart, enabling assessment of test–retest stability under standardized, blinded administration conditions.Results: The participants had an average age of 21.6 ± 3.9 years, with 45% male and 55% female. Total DEQ-5 scores averaged 9.0 ± 5.2 (range: 0– 19); 73.3% scored above the > 6 clinical threshold. Test–retest reliability was good-to-excellent at the scale level (ICC = 0.887; 95% CI: 0.819– 0.931; P < 0.001). At the item level, Spearman ρ ranged from 0.679 to 0.861, all P < 0.001, and quadratic weighted κw from 0.650 to 0.853. Internal consistency was good (Cronbach’s α = 0.878). Floor (10%) and ceiling effects (1.7%) were within acceptable psychometric limits.Conclusion: The Arabic DEQ-5 demonstrates strong preliminary reliability and good internal consistency, supporting its application as a psychometrically evaluated screening instrument for DED symptom identification in Arabic-speaking populations. These findings provide a foundation for standardized symptom screening, cross-cultural epidemiological comparisons, and future validation studies in Arabic-speaking communities. The infographic details the translation and preliminary psychometric evaluation of the Arabic DEQ-5. The process includes seven steps: 1. Source from DEQ-5 (English), 2. Forward translation by two Arabic translators, 3. Expert committee with eight specialists, 4. Back-translation by a native English speaker, 5. Cognitive debrief with ten readers, 6. Field test with two observers over two sessions and 7. Validation for clinical use of the Arabic DEQ-5. The study cohort consists of 60 Arabic-speaking adults aged 18 to 40 years, with two observers conducting two sessions 2 to 5 days apart. The results show an ICC test-retest reliability of 0.887 with a 95 percent confidence interval of 0.819 to 0.931, an internal consistency of 0.878 across the five DEQ-5 items and 73.3 percent symptomatic dry eye with a score greater than 6 as the clinical cut-off.Infographic on Arabic DEQ-5 translation and psychometric evaluation process and results.Keywords: dry eye disease, DEQ-5, Arabic translation, preliminary psychometric evaluation, questionnaire, psychometric properties