Visual Function Questionnaire
Do you have any difficulty, even with glasses, reading small print such as labels on medicine bottles, a telephone book or food labels?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, reading a newspaper or book?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, seeing steps, stairs or curbs?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, reading traffic signs, street signs or store signs?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, doing fine handwork like sewing, knitting, crocheting or carpentry?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, writing checks or filling out forms?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, playing games such as bingo, dominos, card games, or mahjong?
Yes
No
Not applicable
Do you have any difficulty, even with glasses, watching television?
Yes
No
Not applicable
Submit