Dry Eye Self-Test Step 1 of 7 14% 1. In the last 30 days, how often have your eyes felt uncomfortable?(Required) Never Rarely Occasionally Often Constantly 2. By the end of the day, how intense was the discomfort?(Required) Never Uncomfortable Moderately Uncomfortable Not too Uncomfortable Very Uncomfortable Slightly Uncomfortable Extremely Uncomfortable 3. In the past 30 days, how often did your eyes feel dry?(Required) Never Rarely Occasionally Often Constantly 4. In the past 30 days, how often were your eyes excessively watery?(Required) Rarely Occasionally Often Constantly 5. Do you want to learn more about treatment options to alleviate your dry eye symptoms?(Required) Yes No 6. To what email should we send the results? 7. Are you interested in discussing dry eye treatment options with one of our specialists? Yes No What phone number can we call/text you at?Name First Last Δ
