Do you experience EYE DISCOMFORT? *

Yes

No

During a typical day in the past month, how often did your eyes feel discomfort? *

Never

Rarely

Sometimes

Frequently

Constantly

When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day, within two hours of going to bed? *

Never

Rarely

Sometimes

Frequently

Constantly

Do you experience EYE DRYNESS? *

Yes

No

During a typical day in the past month, how often did you fell dryness in your eyes? *

Never

Rarely

Sometimes

Frequently

Constantly

When your eyes felt dry, how intense was this feeling of dryness at the end of the day, within two hours of going to bed? *

Never

Rarely

Sometimes

Frequently

Constantly

Do you have WATERY EYES? *

Yes

No

During a typical day in the past month, how often did your eyes look or feel excessively watery? *

Never

Rarely

Sometimes

Frequently

Constantly

First Name

Last Name

Email *

Phone *