Ames et al. should be commended for their paper as it is important to carefully measure patient-centered outcomes. However, their choice of scale deserves further comment.

When de Boer et al. reviewed the psychometric properties of existing vision-related quality of life questionnaires, Rasch scaling for questionnaire scoring was one of the criteria for rating a questionnaire’s quality. Therefore it would be helpful for Ames et al. to test the scale structure of the VRSQ using Rasch analysis, and possibly revisit the process of item reduction on a larger dataset.

Konrad Pesudovs
Centre for Clinical Research Excellence in Ophthalmology Outcomes Research, Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia

Author’s Response:
We would like to thank Dr. Pesudovs for his interest in our recent publication on the development of a symptom questionnaire for virtual reality viewing.

Shelly L. Ames, James S. Wolffsohn, Neville A. McBrien
Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia