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SPEED™ Questionnaire

SPEED™ Questionnaire


  • For the Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire, please answer the following questions by checking the box that best represents your answer. Select only one answer per question.

    1. Report the type of SYMPTOMS you experience and when they occur:

  • 2. Report the FREQUENCY of your symptoms using the rating list below:

    0 = Never
    1 = Sometimes
    2 = Often
    3 = Constant

  • 3. Report the SEVERITY of your symptoms using the rating list below:

    0 = No Problems
    1 = Tolerable - not perfect, but not uncomfortable
    2 = Uncomfortable - irritating, but does not interfere with my day
    3 = Bothersome - irritating and interferes with my day
    4 = Intolerable - unable to perform my daily tasks
  • Add your name, phone number and email address to see your results:

  • Click “submit” to see your SPEED score results.
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COVID-19 UPDATE

Due to the coronavirus outbreak and the potential community spread of the virus, the clinic will be closed on the recommendation of the College of Optometrists of Ontario. For the safety of our patients, staff and doctors we will remain closed until at least March 30th, 2020. This may change as the directives change from the Ministry of Health and College of Optometrists, and we will continue to update our patients.

If you need to contact the office about any emergency matters during this time please email us at reception@ancasterfamilyeyecare.com with details and we will get back to you as soon as possible. These emergencies would include sudden changes to vision or ocular injuries. We will also be checking our voicemails on a regular basis.

Thank you for your understanding, please keep you families safe at this time.