Self test new – Brinton Vision – Lasik St. Louis

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Vision starting point

👓

Start with what you rely on every day.

Your current correction gives the team context for the rest of your answers.

✓ This helps personalize the distance and near-vision questions.

→ The quiz language adapts based on your answer.

Question 1 of 9 11%

Step 1

I most often wear

Choose the option that best describes what you rely on most often.

👓 glasses ◎ contacts 🔍 readers ✓ none of these

Please select an answer to continue.

Step 2

What is your age range?

This helps guide the conversation around which vision correction options may be worth discussing.

1 15-44 2 45-55 3 56-106

Please select an answer to continue.

Step 3

Without my glasses I have trouble reading street signs

Tell us how your distance vision feels in everyday life.

✓ yes – no

Please select an answer to continue.

Step 4

I've been told I have astigmatism

Astigmatism is common and helpful for our team to know about.

✓ yes – no

LASIK can now correct astigmatism!

Please select an answer to continue.

Step 5

Without my glasses I have trouble reading my cell phone

This helps us understand whether near vision is part of your daily frustration.

✓ yes – no

Please select an answer to continue.

Step 6

How well do you see at night?

Night vision is one reason a detailed diagnostic exam matters.

☾ very well ◐ ok, but could do better ! quite poorly

Please select an answer to continue.

Step 7

When choosing your vision correction surgeon, which factors matter most to you?

Select all that apply.

★ experience of the surgeon ⌁ technology 🛡 safety $ affordability → convenience

Please select at least one answer to continue.

Step 8

Would your life improve if you were less dependent on glasses and contacts?

Think about work, driving, travel, exercise, mornings, and everyday convenience.

✓ absolutely! ? maybe – not really

Clear eyesight, every waking moment, makes people more active and healthy!

Please select an answer to continue.

Step 9

If you are a candidate, when would you like to have your procedure?

This helps our team understand your timing and urgency.

1 ASAP 2 next few months 3 More than three months out

Most LASIK patients return to work the next morning!

Please select an answer to continue.

Final Step

Calculating your results...

We are preparing your personalized self-test results. Complete your contact information below to see your results.

Calculating your results.....

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