Is your child myopic (Needs glasses or contact lenses to see clearly at a distance)? Is Your child Between the ages of 4 and 18? Is an immediate family member (father, mother or sibling) myopic?
(select YES even if that family member has had LASIK or another refractive surgery procedure for myopia)
Approximately how many hours per day does your child spend on close work (reading and using electronic devices, etc.)?
Approximately how many hours per day does your child spend outdoors, including school recess/breaks?