Lens Surgery - Vision Assessment

Birthday

Do you have someone to assist you post-surgery if needed?

Do you experience blurry or worsening vision?

Do you have difficulty seeing objects up close or at a distance?

Are you experiencing glare or halos around lights?

Do you struggle with night vision?

Has your dependence on glasses or contacts increased?

What are your visual goals after surgery? (Check all that apply)*

What is your daily screen time (computer, smartphone, tablet)?*

Do you have any specific visual needs or hobbies that are important to you? (e.g., reading, sports, driving at night)*

Are you willing to use reading glasses if necessary, after surgery?*

Have you had any previous eye surgeries??*

Do you have any pre-existing eye conditions (catracts, glaucoma, macular degeneration, etc.)?

Do you have any systemic health conditions (diabetes, hypertension, etc.)?

Are you taking medications that may affect vision or healing?

Are you interested in reducing or eliminating your need for glasses/contact lenses?

Do you understand that lens replacement surgery is a permanent procedure?

Do you have any concerns or questions about the procedure?