Mobile health and postoperative self-care following glaucoma, cataract, or corneal transplant surgeries | BMC Ophthalmology

Findings related to application design

The functional requirements and services incorporated into the self-care mobile health application for patients after glaucoma surgery, cataract removal, and corneal transplantation were identified based on a comprehensive literature review and a needs assessment conducted through patient interviews. According to the defined functional requirements, the application needed an appropriate name; therefore, the name “INOOR” meaning vision or sight was selected to reflect its focus on ocular health. The application logo was inspired by themes related to eye health.

To ensure data confidentiality, user authentication is required. Upon registration which includes creating a username and password the user must be authenticated by the application before gaining access to the main interface. Users must be able to enter essential personal and medical information, including their name, surname, age, specific eye condition, and any underlying health issues.

The application must also provide reminders for timely medication use and scheduled medical appointments. Additionally, it should include educational content on eye anatomy, various surgical techniques for glaucoma, cataract, and corneal transplantation, as well as information on the nature, symptoms, and complications of common eye diseases, aimed at increasing user awareness.

For postoperative self-care, the application must offer tailored guidelines for each type of surgery. These include sections on ocular hygiene practices, appropriate nutrition, instructions for daily activities, medication management, situations requiring immediate medical attention, and strategies for addressing patients’ psychological and social needs following surgery. Given that the primary user base comprises Iranian and Persian-speaking patients, the INOOR application was designed with a bilingual interface (English and Persian) to maximize accessibility and cultural relevance.

Moreover, users should have the option to return to the home page or exit the application from any screen within the system (see Table 1).

The main services integrated into the application include patient data registration and editing, delivery of ophthalmic medical information, self-care guidelines, and reminder management (see Fig. 1).

Home screen of the “INOOR” mobile health application

The first service pertains to the registration and editing of patient information. Users can enter and update their personal and clinical data within the mobile health application to ensure accurate and personalized use.

The second service involves the provision of medical information related to ocular health. This includes educational content on eye anatomy, common eye diseases, and the various surgical techniques used in glaucoma surgery, cataract removal, and corneal transplantation.

The third service focuses on self-care guidelines (see Fig. 2), which are divided into three distinct sections:

1. 1.

   Self-care instructions following glaucoma surgery.

2. 2.

   Self-care instructions following cataract surgery.

3. 3.

   Self-care instructions following corneal transplantation.

Self-care instructions screen

Each section provides specific guidance on topics such as eye hygiene, appropriate dietary recommendations, instructions for daily activities and lifestyle, medication management, follow-up appointments, and strategies for addressing psychological and social needs after surgery. All relevant educational materials comprising textual content, images, and instructional videos are made accessible to users. Upon selecting each section, users can view step-by-step instructions supported by visuals and video demonstrations.

Furthermore, all educational content is developed based on credible medical literature and internationally recognized websites, and is reviewed and validated by a specialized expert panel. The information is then presented in a simplified, user-friendly format to facilitate understanding and promote adherence.

The fourth service enables users to record medication information and medical appointments. The application can generate timely alerts and reminders regarding medication schedules and physician visits, helping patients maintain adherence to their postoperative care plans.

Application evaluation findings

The application was evaluated by a total of 30 patients, including 10 who had undergone glaucoma surgery, 10 who had cataract surgery, and 10 who had corneal transplantation. Among these participants, 17 (56%) were male and 13 (44%) were female. In terms of educational background, 19 participants (63%) held a high school diploma, 9 (30%) had a bachelor’s degree, and 2 (7%) held a master’s degree. Regarding age distribution, 2 participants (6%) were between 45 and 50 years old, 5 (17%) between 50 and 55 years, 10 (33%) between 55 and 60 years, and 13 (44%) were aged 60–66 years. In addition, the application was evaluated by five ophthalmology specialists. Concerning their professional experience, one specialist (20%) had 5–10 years of experience, two (40%) had 10–15 years, and another two (40%) had 15–20 years of experience.

The average score from patient responses regarding the usability and user interface of the application was 12.43 (SD = 1.24, Range = 10–14, 95% CI: 11.95–12.91), indicating general satisfaction. The combined average rating from both patients and ophthalmologists concerning the application’s services and overall features was 8.96 (SD = 1.05, Range = 7–11, 95% CI: 8.58–9.34), which is considered satisfactory. Furthermore, the overall user satisfaction score was 3.43 (SD = 0.57, Range = 2–4, 95% CI: 3.22–3.64). Thus, the total mean score across user interface, service features, and overall satisfaction was 24.82 (SD = 2.22, Range = 20–28, 95% CI: 23.97–25.67), which, based on the predefined scoring scale, suggests that the application achieved an acceptable level of user satisfaction. A one-way ANOVA was conducted to compare the total satisfaction scores across the three patient subgroups (glaucoma, cataract, and corneal transplant). No statistically significant difference was found between the groups [F (2, 27) = 0.451, p = 0.642], indicating that the application’s acceptability was consistent regardless of the type of surgery undergone (see Table 2).