Take the Symptoms Survey "*" indicates required fields Vision blurs when reading, writing, or working on computer* Never Seldom Occasionally Frequently Always Headaches when reading, writing, or working on computer* Never Seldom Occasionally Frequently Always Burning, itching or watery eyes when reading* Never Seldom Occasionally Frequently Always Difficulty copying from the whiteboard/smartboard at school* Never Seldom Occasionally Frequently Always Holds books too close; leans too close to computer screen* Never Seldom Occasionally Frequently Always Words break into two or appear to move when reading* Never Seldom Occasionally Frequently Always Tilts head or closes/covers one eye when reading* Never Seldom Occasionally Frequently Always Avoids near work such as reading or writing* Never Seldom Occasionally Frequently Always Trouble keeping attention on reading material* Never Seldom Occasionally Frequently Always Loses place while reading* Never Seldom Occasionally Frequently Always Skips over or leaves out small words when reading* Never Seldom Occasionally Frequently Always Difficulty lining up numbers when doing math* Never Seldom Occasionally Frequently Always Has trouble writing in a straight line* Never Seldom Occasionally Frequently Always Clumsy, bumps into things, knocks things over* Never Seldom Occasionally Frequently Always Trouble understanding reading / low reading comprehension* Never Seldom Occasionally Frequently Always Forgetful / poor memory / loses belongings/things* Never Seldom Occasionally Frequently Always Does not use time well / difficulty finishing assignments on time* Never Seldom Occasionally Frequently Always Responds "I can't" before trying* Never Seldom Occasionally Frequently Always This field is hidden when viewing the formTotalName* First Last Email*
