眼睛健康指數 – 乾眼症問卷調查
Dry Eye Questionnaire (OSDI)

眼睛健康指數 – 乾眼症問卷調查 Dry Eye Questionnaire (OSDI)


請就過去一星期的眼睛狀況回答以下問題，並選擇最接近您眼睛狀況的選頂。

完成問卷後，您將會即時得悉結果。如測試結果顯示有乾眼症，首80名參與人士可以優惠$500專享乾眼症及眼睛健康檢查，本次檢查由眼科專科醫生及視光師主理。立即行動，找出乾眼根源！

Please provide your responses to the following questions regarding the condition of your eyes in the past week. Please select the option that most accurately reflects your current situation.

Once you have completed the questionnaire, you will promptly receive your results. If the results indicate that you are suffering from dry eyes, take advantage of our exclusive offer if you are the first 80 respondents: receive an exclusive offer of $500 on comprehensive dry eye and eye health examinations administered by our Specialist in Ophthalmology and Optometrist. Don't hesitate, act now to identify the underlying cause behind your dry eyes!

1. 名稱 Name

2. 假如您的測試結果顯示有乾眼症，請問你希望本診所職員主動致電或透過whatsapp聯絡你安排眼睛健康檢查嗎？（只適用於首80名參與人士：可以優惠$500專享由眼科專科醫生及視光師主理的乾眼症及眼睛健康檢查）If the results indicate that you are suffering from dry eyes, would you prefer our clinic staff contact you directly via call or whatsapp to further arrange an comprehensive dry eye and eye health examinations? (Only applies to the first 80 respondents: receive an exclusive offer of $500 on comprehensive dry eye and eye health examinations administered by our Specialist in Ophthalmology and Optometrist)
3. 電郵 Email (可選擇填寫 Optional)

4. 電話/Whatsapp | Call/Whatsapp (可選擇填寫 Optional)

5. 年齡 Age
6. 性別 Gender
7. 眼睛對光線敏感（畏光）？Eyes sensitive to light?
8. 眼睛出現異物感？Eyes that feel gritty or have foreign body sensation?
9. 眼睛出現疼痛不適？Painful or sore eyes?
10. 眼睛出現視力模糊（看東西時模糊不清）？Blurred or poor vision?
11. 視力模糊影響日常生活或工作？Blurred or poor vision leads to limitation at work or daily life?
12. 在冷氣地方，眼睛有否出現不適？Will you feel uncomfortable at eyes in places that are air conditioned?
13. 在乾燥環境（如長途飛機），眼睛有否出現不適？Will you feel uncomfortable at eyes in places with low humidity (e.g. long-haul flight)?
14. 在大風環境，眼睛有否出現不適？Will you feel uncomfortable at eyes in windy conditions?
15. 眼睛不適有否影響您觀看電視？Are there any limitations caused by eyes when watching TV?
16. 眼睛不適有否影響您使用電腦、智能電話等電子產品？Are there any limitations caused by eyes when using electronic products such as computer, smartphone?
17. 眼睛不適有否影響您在夜間駕駛？Are there any limitations caused by eyes when driving at night?
18. 眼睛不適有否影響您在閱讀？Are there any limitations caused by eyes when reading?
19. 請問你希望收到電郵或短訊有關不同檢查優惠的推廣或健康資訊嗎？Would you like to receive email or SMS on different health screening promotions or health information in future?

 

立即預約 / 查詢 Book Now / Enquiry：


2155 1321
(楷和眼科中心 Chiron Eye Centre)


6175 0273