Impact of written and photographic instruction sheets on patient behavior after cataract surgery

To evaluate the extent to which patients unnecessarily restrict activities of daily living after routine cataract surgery and to test interventions to increase activity.

Day treatment center, London, United Kingdom.

In this nonrandomized interventional clinical study, consecutive patients having routine first-eye sutureless small-incision cataract surgery received 1 of 3 of the following postoperative instructions: standard discharge instructions informing patients that they could continue all activities of daily living (standard group), an additional written sheet specifying 9 activities of daily living that are safe to perform (written group), or an additional sheet with photographs of people performing safe activities of daily living (photo group). Three weeks postoperatively, patients answered a questionnaire on whether they had avoided the activities of daily living and if so, why.

Each group comprised 50 patients. Sixty-four percent in the standard group reported avoiding 1 or more activities of daily living. The percentage was 44% in the written group (P = .07) and 30% in the photo group (P = .0013). In all groups, the decision to avoid activities was self-directed more than 50% of the time; it was based on the advice of a nurse in 17% of cases and of a doctor in 4% of cases.

Many patients unnecessarily avoided activities of daily living after cataract surgery. Providing an additional written sheet did not significantly improve this, whereas a photograph sheet did. Better awareness of the safety and rapid rehabilitation after modern cataract surgery is needed in hospitals and primary care centers.