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Purpose To develop and psychometrically validate a questionnaire to measure patient distress with preoperative fasting related to cataract surgery. Methods In this single-centered cross-sectional study, consecutive sampling of cataract patients was undertaken immediately preoperatively from February to December 2019. A questionnaire evaluating patient distress with fasting was designed and administered. Questionnaire development occurred in an iterative process and was conducted with consultation from expert investigators and patients. Validation an