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Cataract Self-Test
Take this test to determine if you are ready for Cataract Surgery.
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Email
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Your email
Name:
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Your answer
Phone:
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Your answer
1. What is your age?
Under 18
19-39
40-59
60+
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2. Despite using your glasses, do you have difficulty seeing things far away like road signs or your television?
Yes
No
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3. Despite using your glasses, do you have difficulty reading small print, such as medicine bottles and food labels?
Yes
No
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4. Despite using your glasses, do you have difficulty with fine handwork like knitting or sewing?
Yes
No
Other:
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5. Do you see a glare or halos around lights when driving at night?
Yes
No
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6. Do you have poor vision at night that makes it difficult to drive?
Yes
No
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7. Does your blurry vision make it difficult to do some of your daily tasks?
Yes
No
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