Arabic translation, cross-cultural adaptation, and validation of the NLDO-SS in DCR Arabic patients

Abstract

Abstract Background Nasolacrimal duct obstruction (NLDO) is a common condition, and its incidence increases with age. It is the most frequent cause of epiphora, often accompanied by irritating symptoms like blurred vision, pain and swelling around the eye, and recurrent infections with purulent discharge. These symptoms can significantly impair patients' quality of life and daily functioning. Subjective outcomes were assessed using nonspecific tools such as the Visual Analogue Scale (VAS) and Glasgow Benefit Inventory (GBI). However, these were gradually replaced by disease-specific instruments such as the Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS). Our aim is to translate and adapt a cross-cultural validated version of the Nasolacrimal Duct Obstruction symptom Score (NLDO-SS) into the Arabic language, a valuable tool to evaluate the long-term outcomes of the endoscopic dacryocystorhinostomy operations. Methods A prospective cohort of 86 NLDO patients and 22 controls was included. The NLDO-SS was translated/validated in accordance with international guidelines. Outcomes were assessed pre- and post-endoscopic DCR for 12 months. Results There was significant difference between all scales and total domain of NLDO score between cases and control group. In the 2-week retest reliability, ICC ranged from 0.704 to 0.886, which was significant for all the scales. Cronbach's alpha coefficient was found to be, ranged from 0.706 to 0.888 for all eight scales and 0.863 for total score. Kaiser–Meyer–Olkin “KMO” analysis was 0.906, and the P -value for Barlett's test of sphericity was < 0.001. Conclusion The Arabic version of the NLDO-SS is a reliable, valid, and culturally appropriate tool for assessing symptom severity in NLDO patients undergoing DCR.