Dynamic Vision Constantia — Lifestyle Update

Welcome back

Good to see you again

This short update helps us prepare for your appointment. It takes about 60 seconds.

Your name

Please enter your name

Mobile number

Please enter your mobile number

Email address

Please enter your email address

As an existing patient we already have your details on file. We just need a quick update on how your eyes and lifestyle have changed since your last visit.

Step 2

How are you using your eyes?

Tell us if anything has changed since your last visit.

What do you mainly use your glasses for these days?

Select all that apply

Computer work

Reading

Driving

Outdoor / sport

Distance vision

All of the above

Please select at least one option

How many hours per day do you spend on a screen?

0 – 2 hours

2 – 5 hours

5 – 8 hours

8+ hours

Please select an option

Do you drive at night regularly?

Yes, regularly

Occasionally

Rarely or never

Please select an option

Do you spend significant time outdoors?

Yes — sport, gardening, outdoor work

Mostly indoors

Please select an option

Step 3

Any changes since your last visit?

Even small changes are worth mentioning — they help us tailor your exam.

Have you noticed any changes in your vision?

Yes — my vision has got worse Blurrier, harder to read, more strain

Yes — something feels different Not necessarily worse, just changed

No — my vision feels the same

Please select an option

Any relevant health changes since your last visit? (optional)

Diagnosed with diabetes

High blood pressure

New medication

More headaches

Dry / irritated eyes

No changes

Is there anything specific you'd like to discuss today? (optional)

When it comes to your eyewear, what matters most to you?

Best value for money Good quality at a competitive price

Balance of quality and cost Happy to invest in something good

Best available technology Performance is the priority

Please select an option

Your answers are confidential and shared only with your optometrist to help prepare for your appointment.

All updated.

Thank you — your optometrist will review this before your appointment. We look forward to seeing you.