Prevent Blindness America: Survey - Adult Vision Risk Assessment

Adult Vision Risk Assessment

Before you take this test, you should know the difference between an eye check or test and an eye exam done by an eye doctor.

1.

Question - Not Required - Do you have a blood relative with glaucoma?

2.

Question - Not Required - Has a doctor treated you for or said you have glaucoma?

3.

Question - Not Required - Have you ever had an eye injury or eye surgery?

4.

Question - Not Required - Have you noticed a change in your vision over the last 12 months?

5.

Question - Not Required - Do you have persistent pain in or around the eye?

6.

Question - Not Required - Are you Black, Hispanic or Latino and age 40 or older?

7.

Question - Not Required - Are you over age 65?

8.

Question - Not Required - Was your last dilated eye exam more than two years ago?

9.

Question - Not Required - Do you have diabetes?

10.

Question - Not Required - If you are diabetic, was your last dilated eye exam more than a year ago?

If you suspect that you are not seeing correctly or have an eye problem, you should arrange for a professional eye exam, regardless of the results of this risk assessment.

11.

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