Am I A Lasik Vision Correction Candidate?

1) My age is:
<18   18-39   40-60   >60

2) I am (may choose more than one):
Nearsighted
Farsighted
Astigmatic

3) I currently wear: (may choose more than one)
Glasses
Soft contacts
Gas Perm (hard) contacts

4) I have been diagnosed with:
Glaucoma
Lupus
Retinal Detachment
Rheumatoid arthritis
Keratoconus
Diabetes
None of the above

5) My hobbies are:
Boating/Water skiing
Snow skiing/boarding
Golf/tennis
Cycling
Swimming/scuba diving
Other

6) Do you have dry eyes?
Yes No

7) Do you have large pupils?
Yes No

8) Are you pregnant or nursing?
Yes No

9) Do you want to decrease your dependence on glasses or contacts?
Yes No

10) Do you tend to be a "perfectionist" who may not be happy with less than "perfect"vision?
Yes No

* - required fields