Are you at risk of dry eye? Assess Yourself

1. QUESTION ABOUT EYE DISCOMFORT

a. During a typical in the past month, how often did your eyes feel discomfort?
Never   
Rarely   
Sometime   
Frequently   
Constantly   


b. When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day, within two hours of going to bed?
Never have it   
Not at all intense    (1)    (2)    (3)   
Very intense    (4)    (5)   

2. QUESTIONS ABOUT EYE DRYNESS:

a. During typical day in the past month, how often did your eyes feel dry ?
Never   
Rarely   
Sometime   
Frequently   
Constantly   


b. When your eyes felt dry, how intense was this feeling of dryness at the end of the day, within two hours of going to bed?
Never have it   
Not at all intense    (1)    (2)    (3)   
Very intense    (4)    (5)   

3. QUESTION ABOUT WATERY EYES:

During a typical day in the past month, how often did your eyes look or feel excessively Waterly ?
Never   
Rarely   
Sometime   
Frequently   
Constantly   

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