Modification of the Neuropathic Pain Symptom Inventory for use in eye pain (NPSI-Eye)

Abstract

Chronic eye pain, which has previously been assumed to be due to ocular surface abnormalities (ie, “dry eye [DE] disease”), has recently garnered attention as a potential indicator of neuropathic ocular pain in some patients. The purpose of this study was to evaluate the psychometric properties of a modified version of the Neuropathic Pain Symptom Inventory in individuals with eye pain (NPSI-Eye). Enrolled participants (n = 397) completed the NPSI-Eye, general pain severity questionnaires, DE symptom report, and psychological health indices. Participants also underwent mechanical pain sensitivity testing of the cornea, tear film assessment, and evaluation of the efficacy of anesthetic eye drops to relieve pain. Short-term test–retest reliability of the NPSI-Eye was excellent (intraclass correlation coefficient = 0.98, P < 0.001). Correlations between the NPSI-Eye and indicators of general eye pain were ≥0.65 (P < 0.001), whereas correlations between the NPSI-Eye and DE symptom severity and psychological health indices were lower (rho = 0.56, 0.32, 0.37; all P < 0.001). Individuals who reported little or no decrease in pain after anesthetic eye drops (hypothesized to indicate eye pain with at least partial central involvement) had significantly higher NPSI-Eye scores than participants whose eye pain was completely relieved by anesthetic (P < 0.05). Overall, our results support preliminary validation of the NPSI-Eye, yielding similar metrics to those reported in Bouhassira et al.'s original NPSI publication (2004). However, additional evaluation and refinement of some questions may be desirable, including the potential elimination of items that were not highly endorsed.

Genomic analysis of 21 patients with corneal neuralgia after refractive surgery

“…Another limitation of our study is the use OSDI, which is not a validated pain assessment tool, as a metric for inclusion based on symptom severity. The NPSI-Eye, 36 not yet reported when enrollment for this study was begun, is likely to provide a useful instrument for future studies.…”

Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

“…[25,26] Recently, the NPSI was appropriately adapted for evaluating ocular pain, and a modi ed NPSI-Eye was later developed during our study period. [27] Among the available questionnaires, we used the OPAS to evaluate patients with ocular neuropathic pain features, because it provides multi-dimensional information not only on the severity of ocular pain but also on associated and aggravating factors and the QoL; moreover, it is a validated questionnaire for ocular pain. [16] Kalangara et al [5] used the term "burning eye syndrome" for a subset of dry eye representing a neuropathic pain of the eye.…”

Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

“…[31,32] Recently, the NPSI was appropriately adapted for evaluating ocular pain, and a modi ed NPSI-Eye was later developed during our study period. [33] Among the available questionnaires, we used the OPAS to evaluate patients with ocular neuropathic pain features, because it provides multi-dimensional information not only on the severity of ocular pain but also on associated and aggravating factors and the QoL; moreover, it is a validated questionnaire for ocular pain. [16] The Pearson's correlation analysis between the Wong-Baker FACES® Pain Rating Scale and the OPAS score showed good correlation between two measures.…”