1.) Does your vision problem cause you difficulty with:

  • Reading
  • Writing
  • Recognizing faces
  • Cooking
  • Eating
  • Telling time
  • Using the telephone
  • Shopping
  • Identifying money
  • Watching T.V.
  • Taking medications
  • Walking around objects in your home
  • Walking outside the home
  • Continuing with current work or educational goals

2.) Have you experienced any falls or accidents because of your vision?

3.) Are you considering moving into an assisted care facility or moving in with family members because of your vision?

4.) What activity is the most frustrating for you since your vision has decreased?