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A private note about eye and screen comfort

Print a blank copy. Record observations by hand to discuss at an examination. This sheet is not a diagnostic score, treatment plan or emergency checklist. Keep it privately; do not email it to Meerawell.

Observe your screen day; this is not a diagnostic score.
Date and timeScreen task, light and airflowWhat I noticedChanges and what happenedQuestions for my eye clinician

Other questions or relevant context

Seek urgent care for sudden vision loss, a painful red eye with light sensitivity or rapidly worsening symptoms. Do not wait for a diary.

Meerawell · General education · No form submission, storage or analytics on this sheet.