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MiSight® contact lenses
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Myopia Management
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Myopia Management
All about myopia
The myopia epidemic
Discover MiSight® 1 day
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Myopia vision simulator
Axial length calculator
All about myopia
The myopia epidemic
Discover MiSight® 1 day
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Myopia management digital resources
Myopia vision simulator
Axial length calculator
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OptiExpert™
About OptiExpert™
Vision Simulator
Efron Grading Scales
Investigator Initiated Studies (IIS)
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Vision Simulator
Efron Grading Scales
Investigator Initiated Studies (IIS)
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Practitioner Site
Follow-up appointment survey
Visit date
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Subject ID
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Site no.
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Patient gender
Male
Female
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Age
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Q1
1. On average how many days and hours has the patient been wearing MiSight® 1 day?
Hours per day:
Days per week:
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2. How noticeable to the child are the ghosting and haloes which are normal visual sensations of the therapy?
Not noticeable
Noticeable, but not affected by them
Noticeable and occasionally affected by them
Noticeable and cannot adapt to them
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3. To what extent is the child able to apply the contact lenses independently?
Always
Most of the time
Sometimes
Never
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4. To what extent is the child able to remove the contact lenses independently?
Always
Most of the time
Sometimes
Never
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5. How much does the child prefer wearing MiSight® 1 day contact lenses compared to their previous correction?
Very much prefers
Somewhat prefers
No preference
Prefers previous correction
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6. To what extent does the parent/guardian feel at ease that the child’s myopia is being managed by MiSight® 1 day contact lenses?
Very much at ease
Somewhat at ease
Neither
Somewhat uncomfortable
Very uncomfortable
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7. What is the likelihood that this patient will continue wearing MiSight® 1 day contact lenses?
Very likely
Somewhat likely
Somewhat unlikely
Very unlikely
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8. Considering all myopia management options, to what degree do you believe MiSight® 1 day is the right option for this patient?
Strongly believe
Believe
Neutral
Do not believe
Strongly do not believe
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Are there any other comments about fitting MiSight® 1 day or comments from either the child or the parent/guardian that you would like to share?
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