LAUSR

PURPOSE To explore cataract patients' experiences with an e-health tool for self-assessing visual function (i.e. a web-based eye test), and to formulate recommendations for its successful adoption in routine cataract care. SETTING Clinics in the Netherlands, Germany and Austria. DESIGN Mixed-methods study. METHODS Questionnaires and in-depth semi-structured interviews were conducted alongside a multicenter randomized controlled trial evaluating the validity, safety and cost-effectiveness of remote care after cataract surgery (CORE-RCT). Results were analyzed thematically. RESULTS A total of 22 participants were included in this study. In-depth interviews were conducted with 12 of them. Participants reported positively about performing the web-based eye test at home. Four overarching themes were identified in the interviews. First, participants were inventive in overcoming practical barriers encountered while conducting the test. Second, participants desired a clear presentation of test results and their meaning. Third, the ability to self-monitor visual function was appreciated. Fourth, most participants preferred to remain the option to contact their eye care professional postoperatively, especially when experiencing symptoms. Most would be satisfied with a phone consultation or an E-consult. CONCLUSIONS Participants reported positive experiences with the studied web-based eye test. Barriers for successful adoption were identified, including: insecurity about correctly performing the test, incomplete information on how to interpret test results, and a feeling that in-hospital assessments are superior to remote assessments. We propose recommendations to focus on building trust in remote eye care delivery, and acknowledging the need to retain access to the ECP when medically indicated or deemed necessary by the patient.