MARKET RESEARCH – Project Dry Eyes

We are looking for people who suffer with Dry Eyes to take part in an online survey.

You will be sent a link and the survey will take 40 minutes to complete

Please answer the questions below.

Name:

Telephone number:

Home Postcode:

Age:

Ethnicity:

Occupation:

Occupation of chief income earner in the household:

Working status i.e. Student, Full time working, part time working, etc.

Who do you live with at home?

If you have children, please tell us their ages

Which of the following have you been diagnosed with?

• Dry Eye disease
• Meibomian gland dysfunction
• Blepharitis
• Rosacea/Ocular Rosacea
• Sjogren’s Syndrome

How long ago were you diagnosed?

Thinking about your eye condition, which of the following best describes the severity?

• Mild
• Moderate
• Severe

When did you last have an eye test by an eye doctor relating to your eye condition?

Which of the following apply to you?

• I wear contact lenses on a regular basis
• I have had a punctual occlusion procedure in the last 60 days
• I have had cataract surgery/laser eye surgery for refractive errors
• I have had an eye injury
• I have experienced a change in systematic medication in the last month
• None of the above

What medication are you taking for your eye condition? Please list all

What medical procedures have you had done for your eye condition, if any?

Please forward this on to anyone you know who may be interested.

Unfortunately, it is impossible to reply to all emails or phone messages.   We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.
 
Kind regards,
 
 
Daliah Salem
trend MARKET RESEARCH LTD