Free Vision Quiz

Please answer each question as it applies to the patient.

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Headaches from near work*
Double vision when reading*
Skips/repeats lines when reading*
Head tilt/closes one eye when reading*
Avoids near work/reading*
Omits small words when reading*
Misaligns digits/columns of numbers*
Poor reading comprehension*
Trouble keeping attention on reading*
Holds reading materials too close*

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