Double Vision Quiz

If you are unsure if there is reason to be checked by an optometrist for double vision, you can take the quiz below which can guide you if there’s a possibility that you are seeing double. It is important to note, however, that if you ever have any questions or concerns about your vision, please don’t hesitate to call us at (360) 491-2121 to schedule an appointment. Our staff will be happy to answer and discuss anything concerning your eye health.

Double Vision Quiz

The following quiz has 3 parts:

Symptoms
Medical history
Scenarios that involve our eyes

Please rank how relevant any of the following symptoms are to you on a typical day, from a scale of 0 to 4.

0 = I never experience this symptom

1 = I seldom experience this symptom

2 = Every now and then I experience this symptom

3 = I frequently experience this symptom

4 = I always experience this symptom

Please select the accurate answer that best describes how common your experience is with these scenarios:

0 = never

1 = once a month

2 = around once a week

3 = a few times a week

4 = every day

If you wear an optical correction, please answer the following questions, as they pertain to when you are wearing your glasses or contact lenses.

Scenarios

	0	1	2	3	4
When you move your eyes, do you feel pain?
Do you notice yourself closing one eye when you’re looking up close?
Do you notice yourself closing one eye when you’re accomplishing tasks at a distance?
Do you skip lines or find yourself losing your place when you’re reading?
Do you tend to use your finger or something like a ruler to keep your place on the page when you’re reading?
Do you notice that when you are doing work up close, such as being on the computer, reading, etc, that you get nauseous, dizzy or light headed?
Do you notice yourself drifting to one side when you walk?
Do you get car sick?
Do you experience blurry vision when looking at targets at a distance, such as watching TV or looking at the board at school?
Do you experience blurry vision when looking at targets up close?
Have you noticed that you have a hard time judging how far away an object is from you?
When you look out to the distance, do you notice that you’re seeing shadows in your vision or that what you are viewing appears to be overlapping with another image?
When you look up close, do you notice that you’re seeing shadows in your vision or that what you are viewing appears to be overlapping with another image?
Do you notice that you get tired when trying to perform tasks up close, such as reading or being on the computer?
Do you notice yourself blinking intensely when you go from looking at a distance, such as watching TV, to looking at something up close, like your cellphone?

If any of your answers were a 4, it is advisable to come see us, and any score above 12 is a sign that it’s a very good idea to be evaluated for double vision.

There is a possibility that double vision is causing the symptoms that you are experiencing and we welcome you to schedule an eye exam.

If you would like a vision therapist to look over your quiz and contact you about your results, please fill out this form.

First Name

Last Name

Phone/Mobile

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There is a possibility that double vision is causing the symptoms that you are experiencing and we welcome you to schedule an eye exam at American Family Vision Clinic. You can call (360) 491-2121 or Book an Appointment and we will be happy to help you.

It can be hard to notice on your own if you or your child has double vision, but certain symptoms can be clues as to whether you or your child may be seeing double. Dr. Levi Zurcher and staff are trained and have experience in diagnosing and treating double vision so we welcome you to schedule an eye exam at American Family Vision Clinic.