• For the Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire, please answer the following questions by checking the box that best represents your answer. Select only one answer per question.
  • 1. Report the type of SYMPTOMS you experience and when they occur:

  • 2. Report the FREQUENCY of your symptoms using the rating list below:

    0 = Never 1 = Sometimes 2 = Often 3 = Constant
  • 3. Report the SEVERITY of your symptoms using the rating list below:

    0 = No Problems 1 = Tolerable - not perfect, but not uncomfortable 2 = Uncomfortable - irritating, but does not interfere with my day 3 = Bothersome - irritating and interferes with my day 4 = Intolerable - unable to perform my daily tasks
  • Add your name, phone number and email address to see your results: