Symptom Quiz

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Symptom Quiz

1
Do your eyes feel tired when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
2
Do your eyes feel uncomfortable when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
3
Do you have headaches when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
4
Do you feel sleepy when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
5
Do you lose concentration when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
6
Do you have trouble remembering what you have read?
Never
Infrequently
Sometimes
Fairly Often
Always
7
Do you have double vision when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
8
Do you feel like you read slowly?
Never
Infrequently
Sometimes
Fairly Often
Always
9
Do your eyes ever hurt when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
10
Do your eyes ever feel sore when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
11
Do you feel a "pulling" feeling around your eyes when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
12
Do you notice words blurring or coming in and out of focus when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
13
Do you lose your place when reading or doing close work?
Never
Infrequently
Sometimes
Fairly Often
Always
14
Do you have to reread the same line of words when reading?
Never
Infrequently
Sometimes
Fairly Often
Always
15
Symptoms - Total ScoreTap submit for recommended next steps
A score of 16 or more indicates the need for a Developmental Vision Exam.
16
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17
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First Name
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