Dry Eye Syndrome: Do You Have Dry Eye?

Dry Eye Syndrome Evaluation Tool

You need Javascript enabled to use this tool.Read through the questions above. For each question, award yourself two points for a "Yes" answer or one point for answering "Sometimes". If you answer "No" then don't add any points for that question.What your score means.If you scored 0 to 6 points:You are unlikely to be suffering from dry eye syndrome.If you scored 7 to 14 points:You are experiencing a number of symptoms of dry eye syndrome. To improve symptoms, blinking frequently may help, drink plenty of water and avoid rubbing your eyes.Over the counter treatments are available from your pharmacy or optometry outlet. If symptoms persist speak to your health care professional.If you scored 15 points or over:You are very likely to be suffering from dry eye syndrome. Consult your eye practitioner or health care professional to determine what treatments are best to alleviate your symptoms.

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	Y	S	N
Do your eyes feel gritty or scratchy?
Do your eyes feel like they're stinging or burning?
Are your eyes watery or red?
Do you take hormone replacement therapy or are post-menopausal?
Do you wear contact lenses?
Do you work at a computer or watch television for long periods?
Are your eyes sensitive to light or dust?
Do you wake up with mucus around your eyelids?
Are your eyes itchy, especially around the corners?
Do you suffer from blurry vision that changes when you blink?
Do you suffer from athritis, asthma or gout?
Do you take antidepressants or corticosteroids?
Do you take diuretics or antihistamines?
Are you over 40 years of age?

	Average no. of cigarettes smoked each day
	No. of cigarettes per pack
	Cost per pack ($)
	Age
	How many years have you been smoking?

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Dry Eye Syndrome Evaluation Tool

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