What’s your first name?
Nice to meet you, !
When is your birthday?
1. Avid screen user (greater than 4 hours a day):
2.Have you been diagnosed with blepharitis or meibomian gland disease?Or are your eyelids red, irritated and itchy with debris on your eyelashes?
3. Have you been diagnosed with demodex?
4. Do you prefer pill or liquid supplement?
5.Do you eat seafood products?
6. Any allergies to seafood/shell fish products?
7. Do you wear eye lash extension or false eye lashes:
7. Some products contain ingredients that are not suitable for fake lashes or eyelash extension wear, please discontinue all fake lashes and extensions while on this specific box. Thank you.
You will now be asked a series of questions from the OSDI questionnaire. The OSDI© is a valid and reliable instrument for measuring dry eye disease (normal, mild to moderate, and severe) and effect on vision-related function. Please choose the best answer that represents your symptoms.Please answer to the best of your ability.
Have you ever experienced any of the following during the last week?
1.Eyes that are sensitive to light?
2.Eyes that feel gritty?
3.Painful or sore eyes?
Have problems with your eyes limited you in performing any of the following during the last week?
7.Driving at night?
8.Working with a computer or bank machine (ATM)?
Have your eyes felt uncomfortable in any of the following situations during the last week?
11. Places or areas with low humidity (very dry)?
12.Areas that are air conditioned?
What’s your email address?
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