IOL Self-Evaluation Test

Name:
Phone:
E-Mail:

How interested are you in seeing at a distance, driving or playing golf without glasses after your cataract surgery?
It's very important to me NOT to wear glasses for distance vision.

It's not important to me. I do not mind wearing glasses.
Are you interested in seeing well up close (reading) without glasses after your cataract surgery?
It's very important to me NOT to wear reading glasses.

It's not important to me. I do not mind wearing reading glasses to see things up close.
If you had to wear glasses after your vision treatment for one of the following activities, which one would you most be willing to wear glasses for?
Reading fine print

Using a computer or cooking

Driving a car
If you could have good vision for driving during the day without glasses, and good near vision without glasses in most situations, would you be able to tolerate some halos and glare around lights at night?
Yes

No
If you could have good distance vision day and night, and good vision for computer work, without glasses, would you be willing to wear glasses for reading fine print and small type?
Yes

No
In our daily lives there are different things we do that require us to SEE at different distances. We have grouped some of these vision activities into 5 lifestyle zones. Think about the things in life you want to do the most without depending on glasses after cataract surgery. Which group is the most important
Newsprint, books, reading maps or sewing.

Computer screens, menus, price tages or headlines.

Watching TV, cooking, cleaning or indoor activties.

Driving, playing golf, seeing road signs.

Night Driving, watching movies.
Consider your personality. Based on the options scale below how would you rank your personality?
Easy Going

In the middle

Perfectionist

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Your Eye Appointment
What to bring with you!

Make the most of your appointment time. Your Doctor will want to review your medical history as well as address your eye care concerns. You will get more out of your appointment if you stop now and prepare.

1. Bring any eyeglasses or contact lenses you currently wear.

2. Bring a list of all current medications.

3. Bring a list of serious illnesses or surgeries in your past.

4. Bring a list of your current illnesses or report on your wellness program.

5. Bring your insurance card and referral from your primary Doctor if your insurance requires a referral. Or, if you are paying cash, bring your credit card or checkbook. Payment will be expected at the time of your appointment and on the day of surgery. You may wish to take advantage of CareCredit or ChaseHealthAdvance, and can apply on-line before your appointment.

Schedule Your Appoinment

See Better After a Cataract Surgery

Cataract patients now have an option to see at both near and far distances after cataract surgery! Individuals suffering from cataracts previously had only a mono-focal lens implant option after surgery. NEW multi-focal IOL technology can now decrease dependence on glasses after surgery.

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What Our Patient Says

“My experience at the Harman Eye Clinic resulted in excellent vision. I was not able to see the alarm clock at night and now after LASIK I can see everything. My vision is 2020 and my lifestyle has drastically improved. I have a much more active life and I never have to worry about taking my contacts in and out”

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Washington Eye Doctors | Second Opinions

If you would like to get a second opinion regarding your eye surgery options it is always better to know before surgery then to make a wrong decision. Because our practice is regarded as one of the regions TOP ophthalmology practices we take second opinions very seriously.

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