Dry Eye SPEED Questionnaire

  • Step 1

Standard Patient Evaluation of Eye Dryness

Symptoms

Report the type of SYMPTOMS you experience and when they occur: 

Dryness, Grittiness or Scratchiness

Soreness or Irritation

Burning or Watering

Eye Fatigue

Frequency

Report the FREQUENCY of your symptoms using the rating list below:

Please provide an answer to ALL questions.

Severity

Report the SEVERITY of your symptoms using the rating list below:

Please provide an answer to ALL questions.

Do you use eyedrops regularly?