Symptom Survey Headaches with near work Never Seldom Occasionally Frequently Always Words run together while reading Never Seldom Occasionally Frequently Always Burning, itchy, or watery eyes Never Seldom Occasionally Frequently Always Skipping/repeating lines while reading Never Seldom Occasionally Frequently Always Tilting head or closing one eye when reading Never Seldom Occasionally Frequently Always Difficulty copying from a chalkboard Never Seldom Occasionally Frequently Always Avoiding near work or reading Never Seldom Occasionally Frequently Always Omitting small words when reading Never Seldom Occasionally Frequently Always Writing uphill or downhill Never Seldom Occasionally Frequently Always Misaligning digits/columns of numbers Never Seldom Occasionally Frequently Always Poor reading comprehension Never Seldom Occasionally Frequently Always Holding books or near work very close to eyes Never Seldom Occasionally Frequently Always Short attention span with near work Never Seldom Occasionally Frequently Always Difficulty completing assignments on time Never Seldom Occasionally Frequently Always Saying "I can't" before trying something Never Seldom Occasionally Frequently Always Clumsiness and knocking things over Never Seldom Occasionally Frequently Always Poor use of time Never Seldom Occasionally Frequently Always Losing belongings or misplacing things Never Seldom Occasionally Frequently Always Forgetting things Never Seldom Occasionally Frequently Always Name First Last Email Result
