Myopia Risk Assessment Form
(Only For Patient Wearing Minus Number)
How many hours does your child/patient sleep in a day ?
Does your child/patient play Outdoor ?
Does your child/patient use Laptop / Mobile / Tablet at Home ?
Does your child/patient watch Television ?
Does your child/patient have to use Andriod Tablet / I pad in school ?
Does your child/patient use glasses ?
At what age there was Onset of Myopia ?
Is there any family history of wearing glasses ?
Is child/patient Posture Incorrect while Watching TV or Reading book ?
What is the speed by which myopia is increasing ?