Eye Health Survey for patients & public in Crawley, Horsham and Mid Sussex & East Surrey CCGs

This survey is anonymised. The results of this survey will help us understand your eye health needs so that we can make improvements to community and hospital eye services in your area.  Questions 27 to 29 are for residents in Crawley, Horsham, Haywards Heath, Burgess Hill, East Grinstead and surrounding areas only.
 
The font size can be increased via your web browser. The survey can also be printed (see the print icon on the bottom left hand page) and posted to:
Katie Chipping
Brighton and Hove Clinical Commissioning Group
Hove Town Hall
Norton Road
Hove
BN3 4AH

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* 1. Which eye health professional did you visit when you were first aware of a sight issue?

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* 2. Which eye health professional were you then referred to?

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* 3. What was the reason for your referral? Tick as many as appropriate.

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* 4. If you were referred for cataract surgery by your Optician did you have the opportunity to discuss the surgical procedure? (if yes go to Q5, if no go to Q10.)

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* 5. Did your Optician discuss the risks and benefits of Cataract surgery?

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* 6. Were you offered choice over where you went for treatment ?

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* 7. If you were to have any follow up treatment post cataract surgery e.g YAG Laser )to treat clouding of the lense after cataract surgery), would you prefer to receive your care at the same hospital where you received your surgery or at a different hospital?

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* 8. Did you receive your YAG Laser treatment in the same hospital where you had your cataract surgery?

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* 9. What mode of transport did you use? Were transport links to this clinic easy to access?

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* 10. If you were referred for any other eye condition, did the health professional explain why you were being referred?

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* 11. Where would you choose to receive your care for eye health?

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* 12. What mode of transport would you/do you use to get to the eye Hospital?

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* 13. What part does your GP play in the management of your eye condition? (tick all that apply)

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* 14. Who plays the central role in your eye care:

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* 15. When you received your diagnosis by your Consultant Ophthalmologist at the Hospital/Eye Clinic were you referred to any of the following? Tick as many as appropriate.

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* 16. What support did you receive?

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* 17. Did your local high street Optician refer you to any of the following services?

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* 18. Do you have a Certificate of Visual Impairment (CVI)? If yes go to Q19 if no go to Q20.

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* 19. If you received a Certificate of Visual Impairment, were you informed of the services and support that would be available to you?

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* 20. Since receiving your diagnosis of your eye condition how has this impacted upon your quality of life?

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* 21. Do you think that you could be better supported to manage your eye condition?

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* 22. If you require regular follow up care/monitoring for a long term eye condition (e.g Glaucoma or Wet AMD) do you understand how regularly you should receive your follow up care/treatment?

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* 23. Do you receive reminders from the hospital regarding your follow up care/ appointments?

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* 24. If you have been prescribed eye drops for your condition, has a health professional shown you how to use them?

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* 25. Are you confident that you know how to administer the eye drops and how often?

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* 26. Do you use your local Pharmacy for advice on over the counter medication for a minor eye issue e.g conjunctivitis or itchy eyes?

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* 27. Crawley, Horsham, Haywards Heath, Burgess Hill and East Grinstead residents only. Have you used your local high street opticians for any of these conditions (please check all that apply)

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* 28. Crawley, Horsham, Haywards Heath, Burgess Hill and East Grinstead residents only. How did you find out about the service? (please check all that apply)

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* 29. Crawley, Horsham, Haywards Heath, Burgess Hill and East Grinstead residents only. If this service was not available where would you have gone for help with your minor eye problem? (please check all that apply)

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