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Vision Self Assessment: What’s Your Risk of a Vision Problem?

What’s Your Risk of a Vision Problem or Eye Disease?

This vision self assessment will help you determine whether you are at risk for age-related eye disease. If you suspect that you are not seeing correctly or are having an eye problem, you should arrange for a professional eye exam, regardless of the results of this risk assessment. Some eye diseases may progress without showing symptoms.

If you answer “yes” to any of these questions, please arrange to see an eye doctor for a complete eye exam.

 

1. Do you have blood relatives with glaucoma? Yes No If you have a grandparent, parent, sibling or child with glaucoma, you are at risk for the disease. Get a dilated eye exam every 2 years to ensure good eye health. Next Question 1. Do you have blood relatives with glaucoma? 2. Has a doctor treated you for or said you have glaucoma? Yes No 2. Has a doctor treated you for or said you have glaucoma? If you already know you have glaucoma, it is important to follow up with your eye doctor regularly and to continue prescribed medications so you can keep your eyesight. Next Question 3. Have you ever had an eye injury or eye surgery? Yes No 3. Have you ever had an eye injury or eye surgery? Eye injuries and surgeries can increase your risk for eye disease. See an eye doctor regularly and be sure to inform him or her about your eye health history. Next Question 4. Have you noticed a change in your vision over the last 12 months? Yes No 4. Have you noticed a change in your vision over the last 12 months? Changes in the way you see should be reported to an eye doctor. If you have not seen an eye doctor about these changes in the last year, make an appointment soon. Next Question 5. Do you have persistent pain in or around the eye? Yes No 5. Do you have persistent pain in or around the eye? Persistent pain not due to sinus problems, allergies, cold, flu, headaches or eye strain may be a sign of a serious eye problem. If your eye hurts continuously, see an eye doctor at an emergency room right away. Next Question 6. Are you black, Hispanic or Latino, and over age 40? Yes No 6. Are you black, Hispanic or Latino, and over age 40? Studies show that people of black, Hispanic or latino heritage are more susceptible to glaucoma at an earlier age. If you are black, Hispanic or Latino and age 40 or older, you are in a risk category for glaucoma. Get a dilated eye exam every 2 years to ensure good eye health. Next Question 7. Are you over age 65? Yes No 7. Are you over age 65? Studies show that anyone age 65 and over is in a risk category for glaucoma. If you are in this category, get a dilated eye exam every 2 years to ensure good eye health. Next Question 8. Was your last dilated eye exam more than two years ago? Yes No 8. Was your last dilated eye exam more than two years ago? A dilated eye exam involves the use of eye drops by an eye doctor to enlarge your pupils. If you are in a risk category for glaucoma, (see questions 1, 6, 7) you should have a dilated eye exam every two years or as recommended by your eye doctor. Next Question 9. Do you have diabetes? Yes No 9. Do you have diabetes? People with diabetes are at risk for diabetic retinopathy (an eye disease that harms blood vessels in the eye) If you have diabetes, you should have a dilated eye exam once a year or as often as your eye doctor advises. Next Question 10. If you have diabetes, was your last dilated eye exam more than a year ago? Yes No 10. If you have diabetes, was your last dilated eye exam more than a year ago? If you have diabetes and have not had a dilated eye exam in the last year, make an appointment with an eye doctor to have one as soon as possible. Download the self-assessment Start over Download the self-assessment Start over

Download a copy of the Adult Vision Risk Assessment

Download a Copy of the Adult Vision Risk Assessment

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Download a pdf copy of the Adult Vision Risk Assessment.

Visión Adulta: Evaluación de Riesgos

Adult Vision Risk Assessment - text only

1. Do you have blood relatives with glaucoma?   Yes/No

If you have a grandparent, parent, sibling or child with glaucoma, you are at risk for the disease. Get a dilated eye exam every 2 years to ensure good eye health.

2. Has a doctor treated you for or said you have glaucoma? Yes/No

If you already know you have glaucoma, it is important to follow up with your eye doctor regularly and to continue prescribed medications so you can keep your eyesight.

3. Have you ever had an eye injury or eye surgery? Yes/No

Eye injuries and surgeries can increase your risk for eye disease. See an eye doctor regularly and be sure to inform him or her about your eye health history.

4. Have you noticed a change in your vision over the last 12 months? Yes/No

Changes in the way you see should be reported to an eye doctor. If you have not seen an eye doctor about these changes in the last year, make an appointment soon.

5. Do you have persistent pain in or around the eye? Yes/No

Persistent pain not due to sinus problems, allergies, cold, flu, headaches or eye strain may be a sign of a serious eye problem. If your eye hurts continuously, see an eye doctor at an emergency room right away.

6. Are you black, Hispanic or Latino, and over age 40? Yes/No 

Studies show that people of black, Hispanic or latino heritage are more susceptible to glaucoma at an earlier age. If you are black, Hispanic or Latino and age 40 or older, you are in a risk category for glaucoma. Get a dilated eye exam every 2 years to ensure good eye health.

7. Are you over age 65? Yes/No

Studies show that anyone age 65 and over is in a risk category for glaucoma. If you are in this category, get a dilated eye exam every 2 years to ensure good eye health.

8. Was your last dilated eye exam more than two years ago? Yes/No

A dilated eye exam involves the use of eye drops by an eye doctor to enlarge your pupils. If you are in a risk category for glaucoma, (see questions 1, 6, 7) you should have a dilated eye exam every two years or as recommended by your eye doctor.

9. Do you have diabetes? Yes/No

People with diabetes are at risk for diabetic retinopathy (an eye disease that harms blood vessels in the eye) If you have diabetes, you should have a dilated eye exam once a year or as often as your eye doctor advises.

10. If you have diabetes, was your last dilated eye exam more than a year ago? Yes/No

If you have diabetes and have not had a dilated eye exam in the last year, make an appointment with an eye doctor to have one as soon as possible.