Dry Eye Assessment Test
Personal Info
Have you experienced any of the following during the last week:
All of the time
Most of the time
Half of the time
Some of the time
None of the time
Eyes that are sensitive to light?
4
3
2
1
0
Eyes that are feel gritty?
4
3
2
1
0
Painful or sore eyes?
4
3
2
1
0
Blurred Vision?
4
3
2
1
0
Poor Vision?
4
3
2
1
0
Subtotal score for answers 1 to 5
0
Have problems with your eyes limited you in performing any of the following during the last week:
All of the time
Most of the time
Half of the time
Some of the time
None of the time
Reading?
4
3
2
1
0
Driving at night?
4
3
2
1
0
Working with a computer or bank machine(ATM)?
4
3
2
1
0
Watching TV?
4
3
2
1
0
No Answer
N/A
N/A
N/A
N/A
Subtotal score for answers 6 to 9
0
Have your eyes felt uncomfortable in any of the following situations during the last week:
All of the time
Most of the time
Half of the time
Some of the time
None of the time
Windy Conditions?
4
3
2
1
0
Places or areas with low humidity (very dry)?
4
3
2
1
0
Areas that are air conditioned?
4
3
2
1
0
No Answer
N/A
N/A
N/A
Subtotal score for answers 10 to 12
0
Your Score is
0
You Should consult Dry Eye Specialist
Visit our Dry Eye Center of Excellence and consult Dry Eye specialist
For more details:
- +91 90008 52020
- 0 - 10 : Normal
- 11 - 30 : Mild
- 31 - 50 : Moderate
- 51 - 100 : Severe
