Visual Needs and Expectations Assessment

 
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Now that you have decided to have cataract surgery, we would like you to take some time to consider your typical activities and then fill out the questionnaire below. This information will allow us to customize your visual outcome to best meet your needs.

Enter a number between 0 and 100. Do not include the % sign in your answer.
Enter a number between 0 and 100. Do not include the % sign in your answer.

On a scale of 1 to 10 with 10 being “very important”, how important is it to you tobe independent of glasses for:

Focus Zone Chart

Although modern intraocular lens implants (IOLs) can provide excellent visual quality, no single lens currently available can provide a full range of clear focus like a healthy young natural lens can. Because of this, please look over the charts below and check the 3 contiguous focus zones that you feel would be the most important for you to have as the uncorrected (no glasses or contacts needed) portion of your vision after surgery.