Table 6.
Question | Answer Choices |
---|---|
Which eye has symptoms? | - One eye (5 points) - Both eyes (1 point) |
When did your symptoms start? | - Within 24 hours (6 points) - Between 24-72 hours ago (3 points) - More than 72 hours ago (1 point) |
Do you have a non-moving curtain or veil or shadow in the side of your vision? | - Yes - No |
Ignoring your floater(s), have you experienced blurred vision? If so, how would you characterize it? | - None - Intermittent - Constant |
If “Yes” OR “Constant” = 14 points If “No” AND “None or Intermittent” = 1 point |
|
When you were a young adult (before any procedures to your affected eye), did you need glasses to see to drive? | - Yes (3 points) - No (1 point) |
Have you had a prior retinal tear or detachment in either eye? | - Yes (10 points) - No (1 point) |
Are you diabetic? | - Yes (1 point) - No (5 points) |
Have you ever gone to the operating room for retinal surgery in either eye? | - Yes (10 points) - No (1 point) |