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Table 4 Modified glaucoma symptom scale

From: A prospective, longitudinal, observational cohort study examining how glaucoma affects quality of life and visually-related function over 4 years: design and methodology

Have you experienced any of the following problems in the last 4 weeks?

(Please respond for both the left and right eye.)

a. Burning, Smarting, Stinging

Left Eye

 

Right Eye

☐ Yes

How bothersome has it been?

☐ Yes

How bothersome has it been?

 

______ Very

 

______ Very

 

______ Somewhat

 

______ Somewhat

 

______ A Little

 

______ A Little

☐ No (Not at all bothersome)

☐ No (Not at all bothersome)

b. Tearing

c. Dryness

d. Itching

e. Soreness, Tiredness

f. Blurry/Dim Vision

g. Feeling of Something in Your Eye

h. Hard to See in Daylight

i. Hard to See in Dark Place

j. Halos Around Lights