Not Sure if You Have Dry Eye?

Take this short quiz to find out if you may be suffering from Dry Eye Syndrome.

• Select your age group
  Under 1818-3940-5960+
• Please select the symptoms you are experiencing
  Dryness, grittiness or scratchinessSoreness or irritationBurningEye fatigueEye painWateringExcess mucusBlurry vision helped by blinking oftenLight sensitivityInflamationRednessNone of the above
• Have you had previous eye surgery?
  YesNo
• How often do you experience these symptoms?
  NeverOftenSometimesAlways
• How severe are your symptoms?
  TolerableUncomfertableBothersomeIntolerable
• Select the conditions that irritate your eyes
  Contact lensesSmokeLightWind/fansComputer screensHeaters or air conditioningDustNone of the above
• Select the conditions you have been diagnosed with
  AsthmaDiabetesGlaucomaLupusThyroid abnormalityRosaceaMenopause of post-menopauseRheumatoid ArthritisSjorgren’s SyndromeNone of the above
• What do you use to control your symptoms?
  Over-the-counter eye dropsMedicated eye dropsArtificial tearsWearing glasses instead of contactsRestasisPunctal plugsNothingOther
• What is your name?*
  First NameLast Name
• What is your phone number?*
• What is your email?*
• Submit
• Should be Empty: