|
I'm interested in laser floater treatment
|
|
|
Visual Functioning
|
|
|
Do you have difficulty with the following activities?
|
|
|
Which eye bothers you?
|
Reading
|
|
Doing fine handiwork
|
Sports
|
|
Playing games
|
Driving and seeing traffic signs
|
|
Watching television
|
Navigating steps, stairs, curbs
|
|
Symptoms
|
|
|
Have you been bothered by:
|
|
|
Seeing persistent floaters
|
Seeing floating "spider webs"
|
|
Blurred/hazy vision
|
Double vision
|
|
Eye pain
|
Flashes of light
|
|
Glare
|
Poor color vision
|
|
Poor night vision
|
Poor vision in low or dim light
|
|
Curtain like vision loss
|
Sudden change in vision
|
|
Unusual or painful sensitivity to light
|
Do you feel that the problem is bad enough to consider laser surgery now?
|
