A

CATARACT SURGERY
CANDIDACY TEST
START YOUR TEST

B

CATARACT SURGERY
CANDIDACY TEST
1
1 / 8
Are you having trouble with your vision?

C

CATARACT SURGERY
CANDIDACY TEST
2
2 / 8
Have you had any previous eye operations (Refractive surgery/LASIK, or lasers)?

D

CATARACT SURGERY
CANDIDACY TEST
3
3 / 8
Do you currently wear anything to correct your vision?
check all that apply



E

CATARACT SURGERY
CANDIDACY TEST
4
4 / 8
Have you been told you have cataracts and require surgery?

F

CATARACT SURGERY
CANDIDACY TEST
5
5 / 8
Think about your vision when looking in the distance (driving, playing golf). How important is it for you to do these tasks without glasses after surgery?


G

CATARACT SURGERY
CANDIDACY TEST
6
6 / 8
Think about your near vision (reading, cell phone). How important is it for you to do these tasks without glasses after cataract surgery?



H

CATARACT SURGERY
CANDIDACY TEST
7
7 / 8
How important is clear night vision for you after cataract surgery?


I

CATARACT SURGERY
CANDIDACY TEST
8
8 / 8
Below are 4 zones of vision. Consider things in life you want to do without dependence on glasses, which group is most important to your lifestyle?
Click here to check all



2 1
CATARACT SURGERY
CANDIDACY TEST
HIGHLY LIKELY
Congratulations, you have been ranked a Highly Likely Candidate for Laser Vision Correction. We would like to confirm the accuracy of these results and discuss which treatment is right for you. One of our LASIK coordinators will be in touch with you soon. Or, if you prefer you are welcome to call at 1111111 our office to start the conversation today!