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乾眼症檢測量表(Ocular Comfort Index)
這份問卷主要在檢測你眼睛的舒適情況(乾眼症)，請針對每個問題選擇適合的答案。
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基本資料
請儘量填寫正確資料，以利正確分析。
姓名
*
綽號也可以~
Your answer
性別
*
男
女
年齡
*
Your answer
有無配戴隱形眼鏡
*
軟式隱形眼鏡(長戴型)
軟式隱形眼鏡(日拋型)
彩隱(美瞳、瞳孔放大片)
硬式隱形眼鏡
客製化隱形眼鏡(多次元鏡片)
無
Other:
你從哪個管道得知此量表?
*
Your answer
E-mail
*
方便寄送分析資料及專業建議給您
Your answer
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