Stahl Vision - Cataract Self Evaluation

(937) 643-2020 | StahlVision.com

Find out if you’d benefit from cataract surgery

Cataract Self-Evaluation

Start Your Test

Have you had prior eye surgery?

YesNo

What is your age group

Under 18 18-40 40-65 Over 65

When did you start wearing glasses?

Under 4040-55Over 55

Have you noticed any deterioration of your vision in the last 5 years

YesNo

Is your vision...(check all that apply)

Blurry or Cloudy
Halos and lights and/or over-sensitivity to light
Poor at night
Double or multiple images in one eye
Not as colorful or as vibrant as it used to be
None of the above

Are you...(check all that apply)

Nearsighted (trouble seeing far away)
Farsighted (trouble seeing close up)
Astigmatism (double images)
Wear bifocals or over the counter reading glasses

Is it most important to you to have...(check all that apply)

Good distance vision (driving, golfing, watching TV)
Good intermediate vision (computer work)
Good close up vision (reading)
All of the above

If you have cataract surgery, how important is it to you to be free of glasses and contacts afterwards?

Very importantNot importantNot sure

If you could enjoy good distance vision during the day for most activities without glasses, would you be able to tolerate some halos or glare at night?

YesNo

Please only submit once, it may take a moment to calculate your results

4235 Indian Ripple Road | Dayton, OH 45440

*Must attend StahlVision’s LASIK Seminar to receive savings. Savings off bilateral procedure. Cannot be combined with other offers or insurance discounts. Some restrictions apply. ©Copyright 2017, Eyemax. All rights reserved.