LASIK Self-Test Step 1 of 7 14% What is your age range?* Under 18 18 - 39 40 - 49 50+ Without my glasses and contacts...*check all that apply I struggle to drive and see things far away (Nearsighted) I struggle to read and see things up close (Farsighted) I have distorted vision and cannot see very well (Astigmatism) What do you usually wear to see?*check all that apply Glasses Contacts Reading Glasses Nothing Do you have any of the following?*check all that apply Prior Eye Surgery Prior serious eye injury Rheumatoid Arthritis Cataracts Lupus Keratoconus Are you pregnant or nursing? None of the above It would be best to wait until after your baby is born before undertaking one of our surgical procedures. I would like to see well at a distance without relying on glasses and contact lenses.Rate this statement on a scale of 1 to 5 with 1 being the lowest. I would like to see well up close without relying on glasses and contact lenses.Rate this statement on a scale of 1 to 5 with 1 being the lowest. Looks like you are a great candidate for LASIK! Please complete the form below so we can setup a consultation!You may not be a good candidate for Lasik… BUT, we can look at one of our other refractive surgical procedures as an option. Please complete the form below so we can setup a consultation for your best options!Name* First Last Email PhoneMessage Δ
