How much difficulty do you have doing work or hobbies that require you to see well up close, such as cooking, sewing, fixing things around the house, or using hand tools? | VFQ | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have finding something on a crowded shelf? | VFQ | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have going down steps, stairs, or curbs in dim light or at night? | ADVS and VFQ | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have walking down steps without handrails or help during daylight? | ADVS and VFQ | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have noticing objects off to the side while you are walking along? | VFQ | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have threading a needle without using a threading device (or help-mate)? | ADVS | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have using rulers, yard sticks or tape measures? | ADVS | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have using a screwdriver? | ADVS | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have preparing meals? | ADVS | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Because of your eyesight, how much difficulty do you have pouring coffee, milk, or other beverages? | COMS | |
No difficulty at all | (100) | |
A little difficulty | (75) | |
Moderate difficulty | (50) | |
Extreme difficulty | (25) | |
Stopped doing this because of eyesight | (0) | |
Stopped doing this for other reasons or not interested in doing this | (not scored) | |
Return to QOL Questionnaires Copyright 2003. The Collaborative Ocular Melanoma-Quality Of Life Study. |