Vision Correction Self Test WHAT IS YOUR AGE? Under 18 18 - 39 40 - 54 55+ DO YOU WEAR ANY OF THE FOLLOWING TYPES OF CORRECTIVE EYEWEAR? Glasses Contact lenses A mix of glasses & contacts Multifocal or progressive lenses Readers I don't use eyewear (but should) WHAT IS YOUR VISION LIKE WITHOUT CORRECTIVE EYEWEAR? Difficulty seeing far away Difficulty seeing nearby Difficulty seeing fine details or reading Overall blurry vision HAVE YOU EVER BEEN DIAGNOSED WITH ANY OF THE FOLLOWING? Astigmatism Cataracts Macular degeneration (AMD) An eye injury Dry eye Glaucoma Diabetic eye disease None of the above (Check all that apply) HAVE YOU HAD A VISION PRESCRIPTION CHANGE WITHIN THE LAST 12 CALENDAR MONTHS? Yes No I'm Not Sure PASS Congratulations! From what you’ve told us, it sounds like you are an excellent candidate for Vision Correction Surgery, including LASIK, implantable contact lenses (ICL), Photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE) surgery. Schedule your consultation at Rosin Eyecare below to learn more about what these life-changing procedures can do for your vision.Result Name First Last Email Phone NON-PASS From your answers, it seems that you may not be an ideal candidate for Vision Correction Surgery — but that doesn’t mean that you don’t have other great options! Rosin Eyecare offers a number of exceptional vision correction alternatives to our surgeries. We recommend that if you’re interested in clearer vision, you should schedule a consultation to learn more about what we can do for your eyes.Result Name First Last Email Phone 40147