Answer the questions below YES or NO to determine if you have a problem.

1. Do the words or letters ever appear jumbled / strange?
2. Do the words or letters reverse or invert?
3. Do the words or letters change sequence?
4. Do the words or letters move to a different part of the page?
5. Do parts of the words or letters disappear?
6. Do you get double vision or multiple images?
7. Do words / letters / background change colour, fade or become “blotchy”?
8. Does the text become hard to observe?
9. Is fixation or tracking difficult?
10. Do you see extra words or letters in the text?
11. Do you have difficulty remembering what you have just read?
12. Do you miscopy words regularly?
13. Do any of the letters or words vibrate?
14. Do you get headaches or discomfort when reading?
15. Do you have difficulty filtering background noise?
16. Are some sounds painful?
17. Do you have difficulty following a moving ball?
18. Do the words or letters crowd?
19. Do you trip or have difficulties with steps or stairs?
20. Do you suffer from allergies?

Results
If you answered YES to more than 6 questions, there is likely to be a problem.

If you answered YES to more than 10 questions, you have a significant problem.

If you are concerned about the results of this survey,

please do not hesitate to contact us.