Due to COVID-19, we need to understand if you are experiencing symptoms or changes that significantly impact your day-to-day life. Please answer the following questions:
1. Is your vision interfering with your work or performing an essential job duty?
2. Have you recently had a change in vision that significantly interferes with your day-to-day function, an eye injury, or loss of vision?
3. Are you currently experiencing pain, unexplained redness, or sensitivity to light in either of your eyes?
4. Are you currently seeing flashes of light, new floating spots, curtains, or obstructions in your line of sight?
5. Are you currently experiencing new or worsening headaches or double vision?
6. Were you told by another healthcare provider that you should see an eye specialist immediately?
