Personal Information
Please enter your name:
What is your age?
18
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Lifestyle and Environmental Risks
Does or did either one of your parents, brothers or sisters suffer from age-related macular degeneration (AMD)?
No
Yes
I don't know
How many cigarettes do you smoke a day?
None
I'm a past smoker
10 cigarettes or fewer
11 to 20 cigarettes
21 to 30 cigarettes
31 to 40 cigarettes
40+ cigarettes
How many portions of fruit and vegetables do you eat per day?
5 portions or more
2 to 4 portions
2 portions or fewer
How many portions of fish and shellfish do you eat per week?
2 portions or more
Fewer than 2 portions
Do you take supplements which contain lutein and zeaxanthin? (If you are not sure check the product information on your supplement container)
Yes
I do take supplements but they do not contain lutein or zeaxanthin
I do not take any supplements
Do you take Omega-3 supplements?
Yes
No
What is your ethnic group?
African American/Black
Hispanic/Latino
Caucasian/ White
What is your BMI (Body Mass Index)?
<25
25 to 30
>30
What is your gender?
Male
Female
During your life how much time would you say you have spent outside during daylight hours?
A little (largely indoors)
Same amount of time indoors as outdoors
A lot (largely outdoors)
What is your cholesterol level?
Normal (less than 220mg/dL)
High (more than 220mg/dL)
I don't know
What is your blood pressure level?
Normal
Well-controlled
Inadequately-controlled
I don't know
Visual Risks
Do you have AMD?
No
Yes
I don't know
Has your eyecare professional told you that you have early-stage AMD which does not yet affect your vision?
No
Yes
I don't know
Your eyecare professional may have measured your macular pigment level. Click on the dropdown menu to enter it.
I don't know
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
What color would you consider your eyes to be?
Dark (dark brown, dark hazel or black)
Medium (hazel or light brown)
Light (blue, green or gray)
Have you ever had cataract surgery?
No
Yes
I don't know