Validation and Reliability of the Hebrew Version of the Vision Quality of Life with Time (VisQuaL-T) Survey in Comparison with the Convergence Insufficiency Symptom Survey (CISS)

Abstract Purpose The Vision Quality of Life with Time (VisQuaL-T) questionnaire assesses the duration individuals can perform visual tasks before experiencing symptoms, thus providing a measure of visual quality of life. Although validated in English, it had not yet been evaluated in Hebrew. This study aimed to translate and validate the VisQuaL-T into Hebrew, assess its test-retest reliability over time, and examine its concurrent validity by comparing it with the Convergence Insufficiency Symptom Survey (CISS), a widely used measure of visual discomfort. Methods Fifty healthy participants (mean age: 23.2 ± 6.2 years; 62% female, age range: 12–34) with best-corrected visual acuity ≥ 0.0 logMAR and stereopsis ≥ 250 seconds of arc were recruited. Participants completed the VisQuaL-T in Hebrew at two time points (14-day interval) and the CISS once. The translation followed a forward-backward method. Non-parametric tests were used due to data distribution. Test-retest reliability was assessed using the Wilcoxon Signed-Rank Test, Bland–Altman plots, and Spearman correlation. Internal consistency was measured via Cronbach’s alpha. Convergent validity with the CISS was assessed using Spearman’s rho. Results The mean VisQuaL-T scores at time 1 and 2 were 2.48 ± 0.50 and 2.39 ± 0.56, respectively (P = 0.10), with no significant differences across individual items (P > 0.05), except item 6 (P = 0.02). Bland–Altman analysis indicated good agreement between administrations, and Spearman correlation showed strong reliability (Rs = 0.80, P < 0.001). The Hebrew version's mean score did not differ significantly from the original English normative data (P = 0.65). The mean CISS score was 18.08 ± 0.93. Internal consistency was high for all questionnaires (Cronbach’s α = 0.80–0.85). A moderate negative correlation between VisQuaL-T and CISS scores was observed (Rs = -0.42, P < 0.001). No significant associations were found with age or gender. Conclusions The Hebrew version of the VisQuaL-T demonstrated high internal consistency, test-retest reliability, and comparability to the original English version. Its moderate negative correlation with the CISS supports its concurrent validity. The VisQuaL-T can serve as a reliable clinical tool in Hebrew-speaking populations for evaluating visual symptoms during sustained visual activity.