Falls Church, VA
703-912-0504
Home
Our Team
Anh Nguyen, MD
David L. Parver, MD
Roshni Patel, OD
Layla Kominiak
Patient Ambassadors
Conditions
Cataracts
Refraction
Keratoconus
Dry Eye
TearCare
Glaucoma
Pterygium
Chalazion
Flashes and Floaters
Macular Degeneration
Procedures
Laser Vision Correction
LASIK Eye Surgery
LASIK Self-Test
PRK
Cataract Surgery
Laser Cataract Surgery
Cataract Self-Test
Lens Implants
Cornea Surgery
Corneal Transplant
DMEK
Cross Linking
Retina Surgery
Implantable Collamer Lens (ICL)
Contact Lenses
Order Contacts Online
Orthokeratology
Cosmetic Procedures
Botox
Dysport
Restylane
Radiesse
Belotero
Peels
Resources
Blog
Patient Testimonials
Patient Forms
Patient Financing
In The News
Optomap
Contact
Request an Appointment
First Name
*
Last Name
*
Phone
*
Email
*
Procedure of Interest
*
Procedure of Interest
Cataract Surgery
Chalazion
Dry Eye
Flashes and Floaters
Glaucoma
Keratoconus
Lens Implants
Macular Degeneration
Pterygium
Refraction
Cataract Surgery
Cornea Surgery
Cosmetic Procedures
Laser Vision Correction
Retina
Ortho-K
Message
*Hours may vary. Please contact us for questions about scheduling
Request an Appointment
Cataract Self-Test
Home
|
Procedures
|
Cataract Surgery
|
Cataract Self-Test
Cataract Self-Test
First Name
*
Last Name
*
Email
*
Phone
1.How interested are you in seeing at a distance, driving or playing golf without glasses after your cataract surgery?
Select Your Answer
It is very important to me NOT to wear glasses for distance vision.
It is not important to me. I do not mind wearing glasses.
2.Are you interested in seeing well up close (reading) without glasses after your cataract surgery?
Select Your Answer
It is very important to me NOT to wear reading glasses.
It is not important to me. I do not mind wearing reading glasses to see things up close.
3.If you had to wear glasses after your vision treatment for one of the following activities, which one would you to most be willing to wear glasses for?
Select Your Answer
Reading fine print
Using a computer or cooking
Driving a car
4.If you could have good vision for driving during the day without glasses, and good near vision without glasses in most situations, would you be able to tolerate some halos and glare around lights at night?
Select Your Answer
Yes
No
5.If you could have good distance vision day and night, and good vision for computer work, without glasses, would you be willing to wear glasses for reading fine print and small type?
Select Your Answer
Yes
No
6.In our daily lives there are different things we do that require us to SEE at different distances. We have grouped some of these vision activities into 5 lifestyle zones. Think about the things in life you want to do the most without depending on glasses after cataract surgery. Which group is the most important
Select Your Answer
Newsprint, books, reading maps or sewing.
Computer screens, menus, price tags or headlines.
Watching TV, cooking, cleaning or indoor activities.
Driving, playing golf, seeing road signs.
Night driving, watching movies.
7. Consider your personality. Based on the options scale below how would you rank your personality?
Select Your Answer
Easy Going
In the middle
Perfectionist
*Hours may vary. Please contact us for questions about scheduling
Request your appointment
First Name
*
Last Name
*
Phone
*
Email
*
Procedure of Interest
*
Procedure of Interest
Cataract Surgery
Chalazion
Dry Eye
Flashes and Floaters
Glaucoma
Keratoconus
Lens Implants
Macular Degeneration
Pterygium
Refraction
Cataract Surgery
Cornea Surgery
Cosmetic Procedures
Laser Vision Correction
Retina
Ortho-K
Message
*Hours may vary. Please contact us for questions about scheduling
Home
Our Team
▼
Anh Nguyen, MD
David L. Parver, MD
Roshni Patel, OD
Layla Kominiak
Patient Ambassadors
Conditions
▼
Cataracts
Refraction
Keratoconus
Dry Eye
▼
TearCare
Glaucoma
Pterygium
Chalazion
Flashes and Floaters
Macular Degeneration
Procedures
▼
Laser Vision Correction
▼
LASIK Eye Surgery
LASIK Self-Test
PRK
Cataract Surgery
▼
Laser Cataract Surgery
Cataract Self-Test
Lens Implants
Cornea Surgery
▼
Corneal Transplant
DMEK
Cross Linking
Retina Surgery
Implantable Collamer Lens (ICL)
Contact Lenses
▼
Order Contacts Online
Orthokeratology
Cosmetic Procedures
▼
Botox
Dysport
Restylane
Radiesse
Belotero
Peels
Resources
▼
Blog
Patient Testimonials
Patient Forms
Patient Financing
In The News
Optomap
Contact
Please ensure Javascript is enabled for purposes of
website accessibility
