Dry Eye Test - I-MED Pharma

Take this questionnaire to rate
the degree of your dry
eye symptoms.
Simply respond to the 14 questions by
choosing the answer that best describes
your current situation.

Start Test

Which one of the following age groups do you fall into?

Under 18
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65+

Have you experienced EYES THAT ARE SENSITIVE TO LIGHT over the last week?

Never
Sometimes
Half the time
Most of the time
All the time

Have you experienced EYES THAT FEEL GRITTY over the last week?

Never
Sometimes
Half the time
Most of the time
All the time

Have you experienced PAINFUL OR SORE EYES over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Have you experienced BLURRED VISION over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Did you have problems with your eyes when READING over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Did you have problems with your eyes when DRIVING AT NIGHT over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Did you have problems with your eyes when USING A COMPUTER OR A BANK MACHINE (ATM) over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Did you have problems with your eyes when WATCHING TV over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Have your eyes felt uncomfortable in WINDY CONDITIONS over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Have your eyes felt uncomfortable in PLACES OR AREAS WITH LOW HUMIDITY (VERY DRY ENVIRONMENTS) over the last week?

Never
Some of the time
Half of the time
Most of the time
All the time

Have your eyes felt uncomfortable in PLACES THAT ARE AIR CONDITIONED over the last week?

Never
Sometimes
Half of the time
Most of the time
All the time

Loading Results

Normal

Marginal

Mild

Moderate

Severe