Reliability and Validity of the Chinese Version of the Ocular Pain Assessment Survey (OPAS-C)

Purpose: Our study aimed to investigate the reliability and validity of a translated Chinese version of the Ocular Pain Assessment Survey (OPAS-C) across different cohorts of ocular surface diseases. Methods: This cross-sectional study included 175 participants, comprising 40 healthy controls, 38 patients with dry eye disease (DED), 46 patients with neuropathic corneal pain (NCP), and 51 patients with diabetes mellitus (DM). The OPAS-C scores were compared between the cohorts for each subscale. The internal consistency was assessed using the Cronbach alpha coefficients, and factor validity was assessed using exploratory factor analysis (EFA). Results: The NCP cohort had higher scores than other cohorts for most subscales, while the DM cohort consistently had the lowest scores for all subscales (all P < 0.05). All subscales of the OPAS-C demonstrated good to excellent reliability for all cohorts, specifically core ocular pain subscales such as ocular pain intensity (past 2 weeks and 24 hours), interference with quality of life, aggravating and associated factors (Cronbach alpha coefficients: 0.715–0.990). EFA revealed a 3-factor model with all questions loading strongly onto the model (factor loading values: 0.447–1.131). Factor 1 (ocular pain and related symptoms subscale) showed excellent reliability (Cronbach alpha coefficient: 0.974), while factor 2 (aggravating and associated factors subscale) and factor 3 (nonocular subscale) showed very good reliability (Cronbach alpha coefficient: 0.882 and 0.871, respectively). Conclusions: The OPAS-C is thus a reliable and valid tool in evaluating ocular pain symptoms across diverse patient cohorts, offering a culturally adapted assessment by bridging linguistic barriers.