Cataract Self-Evaluation Test

The term “cataract” refers to a cloudy lens within the eye. When a cataract is removed, an artificial lens is placed inside the eye to take the place of the human lens that has become the cataract.

Occasionally, clear lenses that have not yet developed cataracts are also removed to reduce or eliminate the need for glasses or contacts. If it is determined that surgery is appropriate for you, this questionnaire will help your surgeon provide the best treatment for your visual needs.

It is important that you understand that many patients still need to wear glasses for some activities after surgery.

Fill out the form below and your information will be forwarded directly to an nJoy Vision patient advocate. Upon review, we’ll contact you to discuss which cataract surgery option may be right for you.

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Do you have trouble seeing far away or up close?*


Please check the single statement that best describes you in terms of night vision?*


After surgery, would you be interested in seeing well without glasses in the following situations?*


If you had to wear glasses after surgery for one activity, for which activity would you be most willing to use glasses?*

If you could have good distance vision during the day without glasses, and good near vision without glasses but the compromise was that you might see some halos or rings around lights at night, would you like that option?*


If you could have good distance vision during the day and night without glasses and good mid-range vision without glasses, but the compromise was that you might need glasses for reading the finest print at near, would you like that option?*


Surgery to reduce or eliminate your dependence upon glasses for distance, mid-range and near vision may be partially covered by insurance if you have a cataract that is covered by insurance. Would you be interested in learning more about this option?*

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