Glaucoma Survey Test #4

Some people are more likely than others to develop glaucoma. To determine your glaucoma risk factor, answer all questions listed below

• Are you over 40?
• Do you have a family history of glaucoma?
• Do you have diabetes?
• Have you been told you may have an eye condition that may lead to glaucoma?
• Are you African-American?

If you answered "Yes" to any of these questions and if you have not had a glaucoma test within the past two years, you should make an appointment with an eye doctor to have a glaucoma test.

Brief Functional Vision Screening Questions
1. Do problems with your vision make it difficult to do some of the things you would like to do?
2. Do you have difficulty reading large print headlines in the newspaper?
3. Do you have difficulty reading regular print in the newspaper, magazines, books?
4. Do problems with your vision make it difficult to watch TV, play cards, sew or enjoy other activities?
5. Do you have trouble reading mail, seeing labels on medication bottles, or seeing prices when shopping?
6. Is it difficult for you to recognize faces of family and friends across an average size room?
7. Has a doctor ever told you that nothing more can be done for your vision?

If you answered "yes," to any of the above questions, please see your eye doctor.

Copyright © 1981, 1985 Sight and Hearing Association (formerly the Society for the Prevention of Blindness). All rights reserved. Reproduction in whole or in part is expressly prohibited.

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