Aurora Vision Training Survey

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Birth date

Our eyes lead the body. If there are difficulties with the visual system, it can cause many problems in many areas of life. Identifying these symptoms in conjunction with behavioral or cognitive traits can help us determine if a vision issue is present.

How often do you notice the following symptoms?

Headaches, dizzy or nauseated from near work like reading, drawing, or crafts(Required)

Burning, itchy, or watery eyes(Required)

Clumsy or uncoordinated, or knocks things over(Required)

Car or motion sickness(Required)

Eyesight becomes worse at the end of the day(Required)

When eye teaming or eye function is not at its best, individuals tend to change their behaviour to accommodate their eyes.

How often, if at all, have you noticed these behaviours?

Say "I can't" before trying something new or unfamiliar(Required)

Lose belongings or things/forgetful or have a poor memory(Required)

Short attention span with near work like reading, drawing, or crafts(Required)

Fall asleep reading(Required)

Avoid playing sports or games(Required)

Avoid near work or reading(Required)

One of the biggest indicators of vision problems is when reading. When your eyes are not functioning or teaming together reading becomes extremely difficult, often leading to stress or anxiety.

When reading, how often do you notice these issues?

Double vision when reading(Required)

Skip or repeat lines when reading(Required)

Tilt head or closes one eye when reading(Required)

Words run together while reading(Required)

Omit small words when reading(Required)

Poor reading comprehension(Required)

Hold reading material too close to your face(Required)

Trouble maintaining attention on reading(Required)

Academic, sport, and social performance are all dependant on visual ability. Poor performance may not be an indicator of intelligence or aptitude, but instead, a byproduct of poor vision.

How often do you notice these indicators?

Write uphill or downhill(Required)

This means that it is difficult to stay within the lines when writing on lined paper. Your sentence either veers upwards or downwards instead of staying relatively horizontal.

Misalign digits or columns of numbers(Required)

Difficulty completing assignments on time(Required)

Find it difficult to copy from the board(Required)

Poor and inconsistent sports performance(Required)

Inaccurately judge distance(Required)

Poor hand-eye coordination(Required)