Dry Eye Questionnaire

SPEED QuestionnaireTM

Complete the Standardized Patient Evaluation of Eye Dryness (SPEEDTM) and fill out your information to see the results!
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Symptoms you're experiencing and how often you experience them:
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Dryness, Grittiness or Scratchiness*
Soreness or Irritation*
Burning or Watering*
Eye Fatigue*

How frequently do you experience your symptoms?
0 = Never, 1 = Sometimes, 2 = Often, 3 = Constant
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Dryness Grittiness or Scratchiness*
Soreness or Irritation*
Burning or Watering*
Eye Fatigue*

How severe are your symptoms?
0 = Not severe, 1 = Tolerable, 2 = Uncomfortable, 3 = Bothersome, 4 = Intolerable
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Dryness, Grittiness, or Scratchiness*
Soreness or Irritation*
Burning or Watering*
Eye Fatigue*
Do you use eye drops for lubrication?*

Fill out your information below to receive your results:

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