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Pediatrics
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Cosmetic
Glasses
Enchroma
Eye Conditions
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General eye care
Pediatrics
Optical Center
Cosmetic
Glasses
Enchroma
Eye Conditions
General Eye Care
Pediatrics
Optical Center
Cosmetic
Glasses
Enchroma
Eye Conditions
Surgery
Patients
About
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Services
General Eye Care
Pediatrics
Optical Center
Cosmetic
Glasses
Enchroma
Eye Conditions
Surgery
Patients
About
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Services
General Eye Care
Pediatrics
Optical Center
Cosmetic
Glasses
Enchroma
Eye Conditions
Surgery
Patients
About
cataract self test
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NAME
EMAIL
PHONE
Which describes your vision best?
Blurry or cloudy
Not as colorful and vibrant as it used to be
Halos around lights and/or over-sensitivity to light
Poor vision at night
Double or multiple images in one eye
None of the above
Do you have difficulty seeing street signs? (curbs, freeway exits, traffic lights, halos/glare around lights)
Yes
No
Do you have difficulty with leisure activities such as sports or hobbies? (playing card games, bingo, dominos or sports such as bowling, hunting, golf, tennis or other)
Yes
No
Do you have difficulty reading books and newspapers with good light, extra blinking and proper glasses?
Yes
No
What is MOST important for you to be able to do WITHOUT glasses?
Read newsprint and books
Computer screen and price tags
Watching TV, cooking and cleaning
Driving or golfing
Night driving or watching movies
COMMENTS OR QUESTIONS
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