Skip to main content

Table 4 Wearing experience questionnaire - 3

From: Evaluating the myopia progression control efficacy of defocus incorporated multiple segments (DIMS) lenses and Apollo progressive addition spectacle lenses (PALs) in 6- to 12-year-old children: study protocol for a prospective, multicenter, randomized controlled trial

  Do you have the following symptoms when you wear spectacles?
NeverSeldomSometimesOftenAlways
1Blurred vision at a long distance12345678910
2Blurred vision at an intermediate distance (e.g., computer)12345678910
3Blurred vision at a short distance (e.g., reading, smartphone)12345678910
4Ghosting image12345678910
5Unstable vision at a distance12345678910
6Unstable vision at close range12345678910
7Difficulty or slowness in refocusing your eye from one distance to other12345678910
8Eyestrain12345678910
9Double vision12345678910
10Dizziness12345678910
11Headache12345678910
  1. Modified from Reference [10]