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Neurolens Questionnaire

neurolens 2017 06 08 blue

neurolens 2017 06 08 blue

Answer these quick questions to determine if you are a candidate

Neurolens Lifestyle Index

This questionnaire is meant to help your doctor understand what you‘re experiencing on a regular basis — whether it‘s caused by your eyes, posture, stress, etc. Your responses will help make sure you receive the best care possible.

-You get headaches of any severity each week (even just a dull ache counts). -Your headaches tend to get worse later in the day.
Stiffness/Pain in Neck/Shoulders
You experience stiffness/tension in your neck/shoulders when you work at a computer or read (this might even be from your posture).
Discomfort with Computer Use
Your eyes get tired, burn, or get red easily when you work at a computer for long hours.
Tired Eyes
Your eyes feel increasingly fatigued/tired as the day goes on.
Dry Eye Sensation
Your eyes progressively feel more dry/sandy/gritty while working at the computer or reading.
You experience dizziness, motion sickness, or vertigo
Light Sensitivity
Bright / Strong lights (vehicle headlights, fluorescent lights etc.) bother you.