SPEED

Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire

For the Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire, please answer the following questions by checking the box that best represents your answer.
1. Report the type of SYMPTOMS you experience and when they occur:

Select all that apply
Dryness, Grittiness, or Scratchiness

At this VisitWithin the past 72 hoursWithin the past 3 monthsNone
Soreness or Irritation

At this VisitWithin the past 72 hoursWithin the past 3 monthsNone
Burning or Watering

At this VisitWithin the past 72 hoursWithin the past 3 monthsNone
Eye Fatigue

At this VisitWithin the past 72 hoursWithin the past 3 monthsNone

2. Report the FREQUENCY of your symptoms using the rating list below:*

	Never	Sometimes	Often	Constant
Dryness, Grittiness, Scratchiness
Soreness or Irritation
Burning or Watering
Eye Fatigue

3. Report the SEVERITY of your symptoms using the rating list below:*

	No Problems	Tolerable	Uncomfortable	Bothersome	Intolerable
Dryness, Grittiness, Scratchiness
Soreness or Irritation
Burning or Watering
Eye Fatigue

Severity Score
Do you use lubrication eye drops?

YesNo
SPEED Score
A SPEED Score of 6 or more indicates Dry Eye Syndrome that should be treated aggressively.

If your score is 6 or more, schedule a Dry Eye Consultation at lighthousevisionct.com and we can alleviate your symptoms!
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Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire