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In this study, the service under evaluation is for paediatric aphakia patients. Soft contact lenses (CLs) are inserted at the time of surgery and remain in-situ for the immediate postoperative period. The aim is for families to undertake daily CLs care by two to four months postoperatively after the initial period of extended lens wear and antibiotic use while wound healing occurs. At four weeks postop, the orthoptists demonstrate CLs insertion / removal to parents. Parents are offered multiple practise sessions and are observed at hospital until they are considered safe in the technique. Education is also provided on issues to look out for such as lost CLs and infection. The study aimed to investigate parental experience of this service. Questionnaires were completed by 20 families over a one-month period. Children had had cataract surgery as babies (mean 2.3 months). Independent CLs care was for a median two years (<6 months to >2 years). Six had found the learning process difficult for insertion / removal. Others did not report a difficult process but this may reflect them being more experienced with longer term care. Eighteen agreed that good teaching was provided, 19 agreed receipt of good emotional support and 19 achieved daily CLs handling within a few months. Most did not feel rushed. All felt appropriately counselled preoperatively and 19 found the written information useful. Eight found insertion harder than removal and four were vice versa. The authors acknowledge their study limitations: skewed sample from the CLs clinic, snap-shot survey, and many were experienced users at the time of study. Additional suggestions from families have been incorporated to develop the service further, including peer support among families.

Service evaluation: orthoptic-led teaching of soft contact lens handling for parents in the management of pediatric aphakia.
Ramm L, Painter S.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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