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Lifestyle Index

This questionnaire is meant to help your doctor understand what you're experiencing on a regular basis — whether it's caused by your eyes, posture, stress, etc. Your responses will help make sure you receive the best care possible

How often do you experience any of these symptoms?

of any severity each week, usually getting worse later in the day
Stiffness / pain in neck / shoulders
when you work at a computer or read
Discomfort with Computer Use
in your eyes (redness, burning) after long hours looking at the screen
Tired Eyes
with increasing feeling of eye fatigue throughout the day
Dry Eye Sensation
feeling progressively more gritty/sandy while working at computer or reading
Light Sensitivity
especially with brighter stronger lights like fluorescents or headlights
or an experience like motion sickness or vertigo