Do I Have Chronic Dry Eye Disease?

Let’s See If You Have a Type of Chronic Dry Eye Disease:

Take this short quiz to evaluate your dry eye symptoms.

Once you’ve completed the assessment, schedule a quick and painless healthy eye exam at iCare Vision and share your quiz results with us. This way, we can understand what you’re experiencing and better tailor your appointment to find you relief fast.

Your name

Your email

What are Your Dry Eye Symptom Frequencies?

1. My eyes feel dry, gritty and scratchy.
Select an optionAll the time.Often.Sometimes.Never.

2. I experience burning/stinging and watery eyes.
Select an optionAll the time.Often.Sometimes.Never.

3. I experience sensitivity to light.
Select an optionAll the time.Often.Sometimes.Never.

4. I experience blurry vision.
Select an optionAll the time.Often.Sometimes.Never.

5. My eyes feel burned.
Select an optionAll the time.Often.Sometimes.Never.

6. My eye irritations complicate my work or daily activities, like watching TV or looking at the computer screen.
Select an optionAll the time.Often.Sometimes.Never.

7. Please complete the following:

Let's Talk About Eye Drops

8. I use artificial tears (also known as over-the-counter lubricant eye drops).
Select an optionTrue.False.

9. My vision improves once I use artificial tears.
Select an optionTrue.False.

10. How often are you using eye drops and other means for short-term relief?
Select an optionMultiple times a day.Once a day.Several times a week.Never/not very often.

11. I have been using artificial tears for a long time.
Select an optionTrue.False.

If you answered true on the question above

12. Please complete the following:

13. I have been using artificial tears for a long time.
Select an optionTrue.False.

If you answered true on the question above

14. Please complete the following:

Just a Few More Questions

15. I wear contact lenses.
Select an optionNoYes, and they’re comfortableYes, but they irritate meI’ve tried, but my eyes seem to be too dry for contact lenses

16. I take medication, such as antihistamines, high blood pressure medication, anxiety medications, others.
Select an optionTrue.False.

17. I have diabetes, an autoimmune disease (like lupus, rheumatoid arthritis, etc.) or another health condition.
Select an optionTrue.False.

18. I’ve had an eye surgery, such as laser surgery.
Select an optionTrue.False.

19. I have dry mouth. (Not sure? Here’s a tip: take the cracker test. Put 3 crackers in your mouth without water. If they dissolve in your mouth within 5 minutes - enough for you to eat them - you do not have dry mouth).
Select an optionTrue.False.

20. I have dry skin.
Select an optionTrue.False.

21. I have aching joints.
Select an optionTrue.False.

22. My dry eyes are getting worse and I think about my eyes all the time.
Select an optionTrue.False.

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