APPENDIX 1
A. SUBJECTIVE QUESTIONNAIRE
Subject Identification : _________ Group A B Visit : 1st follow up 2nd follow-up
Please, answer to all of the following questions about your experience with the contact lenses tried over the last two weeks.
A- QUESTIONS ON COMFORT
1. How many hours per day on average did you wear your lenses ? < 8hrs 8-9hrs 10-11 hrs 12-13 hrs 14-15 hrs >15 hrs
2. On average, how would you rate the comfort of your contact lenses during the day (put a mark on the following scale) ?
a) Upon insertion
Very uncomfortable (0) Very comfortable (100)
b) In the middle of the day
Very uncomfortable (0) Very comfortable (100)
c) During the evening
Very uncomfortable (0) Very comfortable (100)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 33
3. On average, how would you rate the “ease of use” of your lenses (handling, ease of care)
very easy easy
somewhat easy difficult
very difficult
4. How likely are you to recommend these lenses to other contact lens wearers?
Very likely Likely
Somewhat Likely Unlikely
Very unlikely
B- QUESTIONNAIRE ON DAY TO DAY ACTIVITIES How do you rate your VISION DURING THE DAY :
1 5
Very bad Perfect
How would you rate your VISION DURING EVENING
0 5 Very bad Perfect 34
35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
How would you rate your vision while DRIVING DURING THE DAY
0 5 Very bad Perfect
How would you rate your vision while doing COMPUTER WORK
0 5 Very bad Perfect
How would you rate your VISION AT NEAR (reading, newspaper)
0 5 Very bad Perfect
How would you rate your vision doing OUTSIDE ACTIVITIES (sports, walk, etc.)
0 5 Very bad Perfect 64
65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87
TO BE FILLED AT THE END OF THE STUDY ONLY (click the appropriate box) Overall, I prefer the vision provided by :
SOFT LENSES RIGID LENSES
IN the future, I would like to wear:
SOFT LENSES RIGID LENSES
88 89 90 91 92 93 94 95 96 97 98
