Schedule your Appointment Online 855.295.4144 Cataract Self Test How did you hear about us? Select One: Davis Vision Employee Referral Existing Patient Facebook SightMD.com Google Instagram Insurance MD Referral OD Referral Other 1.How interested are you in seeing at a distance, driving or playing golf without glasses after your cataract surgery Select Your Answer It is very important to me NOT to wear glasses for distance vision. It is not important to me. I do not mind wearing glasses. 2. Are you interested in seeing well up close (reading) without glasses after your cataract surgery? Select Your Answer It is very important to me NOT to wear reading glasses. It is not important to me. I do not mind wearing reading glasses to see things up close. 3.If you had to wear glasses after your vision treatment for one of the following activities, which one would you to most be willing to wear glasses for? Select Your Answer Reading fine print Using a computer or cooking Driving a car 4.If you could have good vision for driving during the day without glasses, and good near vision without glasses in most situations, would you be able to tolerate some halos and glare around lights at night? Select Your Answer Reading fine print Yes No 5.If you could have good distance vision day and night, and good vision for computer work, without glasses, would you be willing to wear glasses for reading fine print and small type? Select Your Answer Reading fine print Yes No 6.In our daily lives there are different things we do that require us to SEE at different distances. We have grouped some of these vision activities into 5 lifestyle zones. Think about the things in life you want to do the most without depending on glasses after cataract surgery. Which group is the most important Select Your Answer Newsprint, books, reading maps or sewing. Computer screens, menus, price tags or headlines. Watching TV, cooking, cleaning or indoor activities. Driving, playing golf, seeing road signs. Night driving, watching movies. 7.Consider your personality. Based on the options scale below how would you rank your personality? Select Your Answer Easy Going In the middle Perfectionist 8. If you were to get cataract surgery, which location is most convenient for you? Select Your Answer Amityville Bay Shore – 375 Bay Shore- Pediatricc Brentwood Brooklyn Deer Park East Patchogue Garden City Hampton Bays Harrison Hauppauge Holbrook Hempstead Hewlett Huntington Little Neck Manhattan Port Jefferson Riverhead Rockville Centre Sayville Smithtown Suite 201 Smithtown Suite 109 Southampton Southold West Islip Cataracts Our Cataract Technology Cataract Self Test What You Should Know Your Surgery Experience Intraocular Lens Options (IOLs) Cataract Surgery in Special Clinical Settings Cataract Surgery and LASIK Over 40 Locations To Serve You Contact Us How did you hear about us? Select One: Select One: Davis Vision Employee Referral Existing Patient Facebook Friend/Relative Google Instagram Insurance LASIK Open House Longisland.com MD Referral Mets Campaign OD Referral Other Patient Referral Real Self Website Sightmd.com Street Team/Event Yelp ZocDoc Select Appointment Type: Select One: General Eye Care LASIK Consultation Cataract Evaluation Audiology Cornea Pediatric Ophthalmic Plastic Surgery Retina Neuro-Ophthalmology Uveitis PA Pterygium Uveitis/Medical Retina Optometry Glaucoma Location Select One: Amityville Babylon Bayshore 375 Bayshore 180 Bethpage Brentwood 1758 Brentwood 601 Brooklyn Deer Park East Patchogue Garden City 901 Garden City 520 Hampton Bays Harrison Hauppauge Hempstead Holbrook Huntington Hewlett Little Neck Manhasset NYC 114 NYC 166 NYC Park Avenue Plainview Port Jefferson Riverhead 54 Rockville Centre Sayville Smithtown 201 Smithtown 109 Southampton 186 Southold West Islip Yonkers 970 Yonkers 984 Yorktown Heights Preferred Day of the Week: MON TUE WED THU FRI SAT SUN Preferred Time of Day: Morning Afternoon Evening © Copyright 2021 SIGHTMD All Rights Reserved. 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