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The Macular Service Satisfaction Questionnaire (MacSSQ) was developed in 2004/2005. The MacSSQ is suitable for use in service evaluation and audit. Items included in the measure were generated in focus groups consisting of members of four Macular Disease Society local groups (Leicester, Croydon, Fareham and Basingstoke). After the first focus group a draft questionnaire was prepared. This was completed by subsequent focus group members and modifications were made at each stage. Suitability of wording, layout and comprehensibility of the MacSSQ were investigated during a series of eight cognitive debriefing interviews with members of other Macular Society local groups (Camberley, Guildford and Reading).