DEQ-5 Dry Eye Questionnaire

Please answer the following questions by checking the box that best represents your answer. Select only one answer per question.

1. Eye Discomfort

a. During a typical day in the past month, how often did your eyes feel discomfort?

  Never
  Rarely
  Sometimes
  Frequently
  Constantly

b. When your eyes felt discomfort, how intense was this feeling at the end of the day?

  None
  Mild
  Moderate
  Severe
  Very Severe

2. Eye Dryness

a. During a typical day in the past month, how often did your eyes feel dry?

  Never
  Rarely
  Sometimes
  Frequently
  Constantly

b. When your eyes felt dry, how intense was this feeling at the end of the day?

  None
  Mild
  Moderate
  Severe
  Very Severe

3. Watery Eyes

During a typical day in the past month, how often did your eyes look or feel excessively watery?

  Never
  Rarely
  Sometimes
  Frequently
  Constantly

Calculate Score

Your DEQ-5 Score:

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