"*" indicates required fields

Date*
What type of glasses do you presently wear?*
Do you mind wearing glasses?*
If you had the option NOT to wear glasses after Cataract surgery, would this be appealing to you?*
Would you be content knowing you need glasses for some tasks?*
Are you interested in seeing well AT DISTANCE without glasses after surgery?*
Are you interested seeing well AT NEAR without glasses after surgery?*
If you had to wear glasses after surgery for one activity, for which would you be most willing to wear glasses?*
Do you see halos or rings around lights when driving at night?*
If you could become relatively independent from using glasses, but the compromise would be that you might see halos around lights at night, would you like that option?*

How often do you do the following activities?

1 being rarely and 5 being often.
Reading*
Close Detail Work*
Computer*
Watch TV*
Outdoor Activities*
Night Driving*
How would you describe your personality?*
Which three zones would you prefer to see clearest without eyeglasses after surgery?*
Check three boxes
This field is for validation purposes and should be left unchanged.