Skip to main content
Forsight Vision Care logo
MidwestDryEyelogo
Home » Dry Eye Center » SPEED™ Questionnaire

SPEED™ Questionnaire


  • For the Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire, please answer the following questions by checking the box that best represents your answer. Select only one answer per question.

    1. Report the type of SYMPTOMS you experience and when they occur:

  • 2. Report the FREQUENCY of your symptoms using the rating list below:

    0 = Never
    1 = Sometimes
    2 = Often
    3 = Constant

  • 3. Report the SEVERITY of your symptoms using the rating list below:

    0 = No Problems
    1 = Tolerable - not perfect, but not uncomfortable
    2 = Uncomfortable - irritating, but does not interfere with my day
    3 = Bothersome - irritating and interferes with my day
    4 = Intolerable - unable to perform my daily tasks
  • Add your name, phone number and email address to see your results:

  • Click “submit” to see your SPEED score results.

Forsight Vision Care logo

As of Tuesday evening, March 17, the Centers for Disease Control and Prevention and the American Optometric Association have recommended all routine eye care be deferred until further notice in order to slow the transmission of COVID-19 throughout our community.

We will remain available to triage eye emergencies as well as to help you with routine matters during this challenging time.

During this period of social distancing and quarantine, we must all do our part by restricting activities outside the home except for getting medical care.

Drs. Cohan and Cozzone will do their best to accommodate you in the best way possible. Our staff are coming into the office on a daily basis to check messages/call patients about eyewear/ and order contacts for patients. Please leave a voicemail and they will get back to you on the next business day.  Together we will weather this storm. We are hoping that everyone and their families stay well.

COVID-19 UPDATES

Forsight Vision Care logo

As of Tuesday evening, March 17, the Centers for Disease Control and Prevention and the American Optometric Association have recommended all routine eye care be deferred until further notice in order to slow the transmission of COVID-19 throughout our community.

We will remain available to triage eye emergencies as well as to help you with routine matters during this challenging time.

During this period of social distancing and quarantine, we must all do our part by restricting activities outside the home except for getting medical care.

Drs. Cohan and Cozzone will do their best to accommodate you in the best way possible. Our staff are coming into the office on a daily basis to check messages/call patients about eyewear/ and order contacts for patients. Please leave a voicemail and they will get back to you on the next business day.  Together we will weather this storm. We are hoping that everyone and their families stay well.