The Dry Eye Questionnaire

Please complete this questionnaire if you are interested in coming to our office. Then we can get an idea in advance of the extent of your dry eye.

Ocular Surface Disease Index© (OSDI©)

Please answer the 12 questions below and circle the answer in the box that best suits the question. Check “N/A” if you have never performed the activity in the past week or have never been exposed to the conditions described.


The ELZA Institute

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