Sign In   |   Join COVD
Search Site

Vision Conditions

Learn more about the visual system and vision conditions.
Quality of Life Survey
Share |

 


Indicate below how often the following symptoms are experienced by you or your child.

Once you submit the survey, you will be able to view your results and a list of doctors in your area. 

 

Question
Never
Seldom
Occasionally
Frequently
Always
Headaches with near work
Words run together while reading
Burning, itchy, or watery eyes
Skipping/repeating lines while reading
Tilting head or closing one eye when reading
Difficulty copying from a chalkboard
Avoiding near work or reading
Omitting small words when reading
Writing uphill or downhill
Misaligning digits/columns of numbers
Poor reading comprehension
Holding books or near work very close to eyes
Short attention span with near work
Difficulty completing assignments on time
Saying "I can't" before trying something
Clumsiness and knocking things over
Poor use of time
Losing belongings or misplacing things
Forgetting things




Sign In


Forgot your password?

Haven't registered yet?