RLE Quiz - Ocala Eye

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RLE Quizinsightmg2022-06-24T14:02:38+00:00

RLE Candidacy Quiz

RLE Candidacy Quiz Want to know if you might be a candidate for Refractive Lens Exchange (RLE) or other vision correction procedure?

Take our brief RLE candidacy quiz below to find out if the procedure may be right for you.

Step 1 of 8

12%

Question 1: Please Tell Us How Old You Are*
- Under 18
- 19-39
- 40-59
- 60 +

Question 2: Have You Ever Been Told You Have Astigmatism?*
- Yes
- No

Question 3: Do You Have to Wear Glasses/contacts for:*
- Driving
- Computer
- Reading
- All of the Above

Question 4: Have You Had Any of the Following Procedures on Your Eyes (Lasik, Prk, Rk, Cataract Surgery)?*
- Yes
- No

Question 5: Do You Suffer From Multiple Sclerosis, Lupus, Keratoconus or Diabetic Retinopathy?*
- Yes
- No

What Email Should We Send the Results to?*

What Is Your Name?
First Last

What Phone Number Can We Use to Call/text You?

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