Name: Valley Vision Optometry
Address: 4009 Redford St, Port Alberni, British Columbia, V9Y 3R9, Canada
Telephone: +1-250-724-0933
Price range: $000 - $300

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Any of the following symptoms may indicate a functional vision problem. Please read and check the symptoms that you are currently experiencing. This is a critical step in helping us understand the type and amount of functional vision problem that may exist.

Do you (or your child if you are filling this out on their behalf) experience any of the following?

Check all that apply:

1. Skip lines while reading or copying
2. Lose your place while reading or copying
3. Skip words while reading or copying
4. Substitute words while reading or copying
5. Reread words or lines
6. Reverse letters, numbers, or words
7. Use a finger or marker to keep place while reading or writing
8. Read very slowly
9. Experience poor reading comprehension
10. Experience difficulty remembering what you have read
11. Hold your head very close (within 7-8 inches) to your reading or writing materials
12. Squint, close, or cover one eye while reading
13. Tilt your head in an unusual posture when reading or writing
14. Experience headaches after intense visual activities such as reading or computer work
15. Notice that your eyes hurt or feel tired after close work
16. Feel unusually tired after completing a visual task
17. Experience double vision
18. Notice that vision blurs at a distance when looking up from near work
19. Experience crooked or poorly spaced writing
20. Notice that print seems to move or go in and out of focus when reading
21. Experience poor spelling skills
22. Find that letter or lines “run together” when reading
23. Find that words appear to jump on the page when reading
24. Misalign letters and numbers
25. Make errors when copying
26. Experience difficulty tracking moving objects such as balls, etc.
27. Experience unusual clumsiness or poor coordination
28. Experience difficulty with eye-hand coordination sports such as baseball, etc.
29. Experience an eye that turns in or out
30. See more clearly with one eye than the other with best glasses prescription
31. Feel sleepy while reading
32. Dislike tasks requiring sustained concentration
33. Confuse right and left directions
34. Become restless when working at a desk
35. Tend to lose awareness of surroundings when concentrating
36. Find you must “feel” things to see them
37. Suffer from carsickness or motion sickness
38. Experience unusual blinking
39. Experience unusual eye rubbing
40. Experience dry eyes
41. Experience watery eyes
42. Experience red eyes
43. Experience sensitivity to light

Vision Therapy On Vancouver Island, BC Call 888-506-5729

Vision Quiz

Valley Vision Optometry