Dry Eye Questionnaire 1. Do you experience EYE DISCOMFORT?a. During a typical day in the past month, how often did your eyes feel discomfort?* Never Rarely Sometimes Frequently Constantly b. When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day, within two hours of going to bed?* Never Rarely Sometimes Frequently Constantly 2. Do you experience EYE DRYNESS?a. During a typical day in the past month, how often did your eyes feel dry?* Never Rarely Sometimes Frequently Constantly b. When your eyes felt dry, how intense was this feeling of dryness at the end of the day, within two hours of going to bed?* Never Rarely Sometimes Frequently Constantly 3. Do you have WATERY EYES?During a typical day in the past month, how often did your eyes look or feel excessively watery?* Never Rarely Sometimes Frequently Constantly Score You may have Sjogren's Disease and/or Dry Eye DiseaseYou may have Dry Eye Disease Your eyes are Normal Want to discuss your score? Leave us your info!Our team will contact you to discuss your results within 24-48 business hours. You can also call the office and ask them to check up your results as well.Name* First Last Email* Phone*
