Welcome to our Refractive Lens Exchange (RLE) self test
To Start
Please tell us how old you are
Under 18
19-39
40-59
60+
Question 2:
Have you ever been told you have astigmatism?
Yes
No
Question 3:
Do you have to wear glasses/contacts for?
Driving
Computer
Reading
All of the above
Question 4:
Have you had any of the following procedures on your eyes (LASIK, PRK, RK, CATARACT SURGERY)?
Yes
No
Question 5:
Do you suffer from multiple sclerosis, lupus, keratoconus or diabetic retinopathy?
Yes
No
Question 6:
Which location works best for you?
Question 7:
What phone can we use to call/text you?
Next
Question 8:
What is your first name?
Next
Question 9:
What is your last name?
Next
Question 10 (the final one!):
What is your email?
Submit
Question 1 of 10
Unfortunately you are not a candidate for RLE due to your age (18 or under). If you entered this age by mistake, refresh the page and select your age again.