Manage Dry Eyes

Dry Eyes
Speed II Questionnaire for Dry Eye Disease/Ocular Surface Disease

Report the FREQUENCY​ of dry eye symptoms you are experiencing by checking Never, Sometimes, Often or Constant using the numbering system below: 0=Never, 1=Sometimes, 2=Often, 3=Constant

N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Not at all
Once or twice
Almost every day
About once a day
More than once a day
N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely

Report the SEVERITY​ of your symptoms using the ratings below: 0=No problems 1=tolerable - not perfect, but not uncomfortable 2=Uncomfortable - irritation, but does not interfere with my day 3=Bothersome - irritating and interferes with my day 4=Intolerable - unable to perform my daily tasks

N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Not at all
A little bit
Moderately
Quite a bit
Extremely
N.A.
Within past 3 months
Within the past 72 hours
Today
N.A.
Never
Sometimes
Frequently
A lot/always
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