Cataract Surgery Candidacy Test | Boston & Quincy, MA

First Name(Required)

Last Name(Required)

Email(Required)

Phone(Required)

Are you having trouble with your vision?(Required)

Have you had any previous eye operations? (Refractive surgery / LASIK, or Lasers)(Required)

Do you currently wear anything to correct your vision?(Required)

Reading glasses only, Glasses (Distance, Bifocals, Tri-focals, or progressive), Contact Lenses, No Correction

Have you been told you have cataracts and require surgery?(Required)

Think about your vision when looking in the distance (driving, playing golf). How important is it for you to do these tasks without glasses after surgery?(Required)

Think about your near vision (reading, cell phone). How important is it for you to do these tasks without glasses after cataract surgery?(Required)

How important is clear night vision for you after cataract surgery?(Required)

Below are 4 zones of vision. Consider things in life you want to do without dependence on glasses, which group is most important to your lifestyle? (List all that apply )(Required)

Far (T.V., night driving, road signs, golf), Intermediate (computer, cooking, grocery shelf items, iPad), Near (newsprint, phone book, mops, sewing), Very Near (tying a fly, embroidery, knitting, setting jewerly stones)

Message(Required)

Phone

617.471.5665

Toll Free

877.373.2020

Fax

617.665.6703

Hours

Mon: 7:00AM – 3:30PM
Tues: 8:30AM – 5:00PM
Wed: 8:30AM – 5:00PM
Th: 8:30AM – 5:00PM
Fri: 7:00AM – 3:30PM
*Sat: 8:00AM – 12:00PM
*(Quincy Office Only)

Cataract Surgery Candidacy Testin Boston, MA

Phone

Toll Free

Fax

Hours