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About The Dry Eye Disease Assessment

Welcome to the Dry Eye Questionnaire 5. This test is used around the world to identify patients who may be suffering from the effects of Dry Eye Disease.

A score above 6 means you are likely affected by this condition. If our quiz registers you as a candidate, our team can reach out to help you get started with the Dry Eye Disease Assessment at Fraser Valley Cataract and Laser.

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* 1. During a typical day in the last month, how often did your eyes feel discomfort?

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* 2. When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day? Within 2 hours of going to bed?

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* 3. During a typical day in the last month, how often did your eyes feel dryness?

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* 4. When your eyes felt dry, how intense was this feeling of dryness at the end of the day? Within 2 hours of going to bed?

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* 5. During a typical day in the last month, how often did your eyes feel excessively watery?

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* 6. Would you like to receive more information about treatments for Dry Eye Disease?

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* 7. Name

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* 8. Email

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* 9. Best number to reach you

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