Sections | Items | # of items | Range of scale and answer choices |
---|---|---|---|
Section I: Frequency of wearing glasses | Frequency of wearing glasses | 1 | from 1 "always" to 3 "never" |
Frequency of wearing glasses for distance tasks | 1 | from 0 "none of the time" to 4 "all of the time" | |
Frequency of wearing glasses for distance and near tasks | 1 | from 0 "none of the time" to 4 "all of the time" | |
Section II: Vision without glasses | Self-reported rating of vision without glasses | 1 | from 1 "the worst" to 10 "the best" |
Trouble with vision during the day without glasses | 1 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Trouble with vision at night without glasses | 1 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Satisfaction with overall vision without glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Satisfaction with vision during the day without glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Satisfaction with vision at night without glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Effect of bright light without glasses | 1 | from 0 "it makes it much better" to 4 "it makes it much worse" | |
Trouble with glare and halo without glasses | 6 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Limitations in distance vision without glasses | 7 | from 0 "no limitation" to 4 "extreme limitation" | |
Limitations in near vision without glasses | 5 | from 0 "no limitation" to 4 "extreme limitation" | |
Limitations in social activities without glasses | 5 | from 0 "no limitation" to 4 "extreme limitation" | |
Section III: Vision with glasses | Self-reported rating of vision with glasses | 1 | from 1 "the worst" to 10 "the best" |
Trouble with vision during the day with glasses | 1 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Trouble with vision at night with glasses | 1 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Satisfaction with overall vision with glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Satisfaction with vision during the day with glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Satisfaction with vision at night with glasses | 1 | from 0 "not at all satisfied" to 4 "completely satisfied" | |
Effect of bright light with glasses | 1 | from 0 "it makes it much better" to 4 "it makes it much worse" | |
Trouble with glare and halo with glasses | 6 | from 0 "no trouble at all" to 4 "major or overwhelming trouble" | |
Limitations in distance vision with glasses | 7 | from 0 "no limitation" to 4 "extreme limitation" | |
Limitations in near vision with glasses | 5 | from 0 "no limitation" to 4 "extreme limitation" | |
Limitations in social activities with glasses | 5 | from 0 "no limitation" to 4 "extreme limitation" | |
Section IV: Global questions | Willingness to pay | 2 | from 1 "nothing" to 6 "more than five dollars" |
Recent health and happiness | 2 | from 1 "the worst" to 10 "the best" |