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798 Nicholson St
Fitzroy North, Victoria 3068
Brain
Brain Injury

Brain Injury Vision Symptom Survey (BIVSS)





    • 0 = Never
    • 1 = Seldom
    • 2 = Occasionally
    • 3 = Frequently
    • 4 = Always

    A.Eyesight clarity
    Distance vision blurred and not clear - even with lenses
    Near vision blurred and not clear - even with lenses

    B.Please rate each behaviour

    How often does each behaviour occur? (circle a number)

    Clarity of vision changes or fluctuates during the day
    Poor night vision / can't see well to drive at night

    C.Visual Comfort
    Eye discomfort / sore eyes / eyestrain
    Headaches or dizziness after using eyes
    Eye fatigue / very tired after using eyes all day
    Feel "pulling" around the eyes

    D.Doubling
    Double vision - especially when tired
    Have to close one eye to see clearly?
    Print moves in and out of focus when reading

    E.Light Sensitivity
    Normal indoor lighting is uncomfortable - too much glare
    Outdoor light too bright - have to use sunglasses
    Indoor fluorescent lighting is bothersome or annoying

    F.Dry Eyes
    Eyes feel "dry" and sting
    "Stare" into space without blinking
    Have to rub eyes a lot

    G.Depth Percecption
    Clumsiness / misjudge where objects really are
    Lack of confidence walking / missing steps / stumbling
    Poor handwriting (spacing, size, legibility)

    H.Peripheral Vision
    Side vision distorted / objects move or change position
    What looks straight ahead - isn't always straight ahead
    Avoid crowds / can't tolerate "visually-busy" places

    I.Reading
    Short attention span / easily distracted when reading
    Difficulty / slowness with reading and writing
    Poor reading comprehension / can't remember what was read
    Confusion of words / skip words during reading
    Lose place / have to use finger not to lost place when reading
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