Last updated: August 29th, 2024 do or do not , there is no try What is your age?18-4445-6565+What are you currently wearing? EyeglassesReading GlassesBifocals/Progressive GlassesContact LensesNone of the aboveWithout glasses and/or contacts: I have trouble reading and seeing things up closeI have trouble driving and seeing things that are far awayI have trouble seeing both far and nearDo you currently experience any of the following symptoms? Blurry and/or cloudy visionGlare and/or halos around lightsPoor night visionSensitivity to lightDouble vision in one eye onlyNone of the aboveHave you had any previous eye operations? Refractive surgery (LASIK, PRK, RK)Eye muscle surgeryRetina surgeryGlaucoma surgeryNone of the aboveHave you ever been told you have cataracts and need surgery?YesNoWhat would be your goal outcome after cataract surgery?I am fine with needing glasses all the timeI would like to limit my needs for glasses only to readingI would like to eliminate the need for glasses all togetherWould you like to be contacted to schedule a cataract consultation?YesNo, not right nowYou’re Almost Finished! By submitting this form you consent to receive phone calls, text messages and emails from Summit Eye Care. It is not a condition of purchasing any goods or services. You can opt out at any time, message/data rates may apply, and opting-in includes acceptance of the Privacy Policy and Terms of Use. Communications through this website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.I Agree to the Terms of Use The Doctors at Summit Eye Care of Wisconsin have either authored or reviewed and approved this content.
