Diabetic Retinopathy - Living Well With Low Vision

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- Resources for Eyecare Professionals
- A Low Vision Rehabilitation Delivery Model

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Patients
Caregivers
Healthcare Professionals
- Resources for Eyecare Professionals
- A Low Vision Rehabilitation Delivery Model

Diabetic Retinopathy0 of 20 completed

1: What kind of diabetic retinopathy do you have? (This is very important, so if you aren’t sure, please call your clinic.)
2: Is your diabetic retinopathy unilateral (affecting one eye) or bilateral (affecting both eyes)?
unilateralbilateral
3: Do you also have diabetic macular edema?
YesNo
4: Do you schedule comprehensive eye exams at least once a year?
YesNo
5: Do you wear either prescription glasses or contact lenses?
yesno
6: How is the vision in your best affected eye with lens correction?
7: Are your eyes overly sensitive to glare and/or bright light?
yesno
8: Do you get at least 20 minutes of productive exercise every day?
YesNo
9: Do you currently smoke tobacco?
YesNo
10: Are you currently a student?
YesNo
11: Are you experiencing feelings of depression that you can’t seem to shake?
YesNo

12: How often do you engage in activities outside of the home (traveling, volunteering, participating in or attending events, etc.)?
13: Do you live alone?
YesNo
14: Is there someone whom you consider to be your caregiver?
YesNo
15: Do you live in the United States?
YesNo
16: Are you employed full or part time?
YesNo
17: Are you age 65 or older?
YesNo
18: Are you an active member of a support group, church, retirement community or other opportunity to be with others?
YesNo
19: How are you doing financially?
20: What is your current transportation status?

Your Personalized Results

Congrats! You finished the survey. Now what? View your guide online below or click the button to download a PDF copy.

Your Personalized Results

Congrats! You finished the survey. Now what? View your guide online above or click the button to download a PDF copy.

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