Toggle navigation Load unfinished survey Resume later Exit and clear survey default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. H.2054-1221 Macular Disease You are about to fill in a short survey which will help determine your suitability to this research project. Please be aware that all data you provide us with will be held in accordance with the data protection policy outlined on our website. For further information please visit https://www.healthcareopinions.co.uk/privacy-policy/ (This question is mandatory) What is your name, contact number and email address? First Name Surname Contact Number Email Address Postcode (This question is mandatory) Please tell us your age. Only numbers may be entered in this field. Your answer must be between 1 and 99 (This question is mandatory) Are you... Choose one of the following answers Male Female Prefer not to say Other: (This question is mandatory) Have you been diagnosed with or do you provide support for somebody living with a vision impairment? Choose one of the following answers I have been diagnosed with a vision impairment I provide support to somebody living with a vision impairment None of the above (This question is mandatory) What is your relationship to the person with a vision impairment that you provide support to? Choose one of the following answers Close friend Spouse / partner Family member Carer / Caregiver Other: (This question is mandatory) Do you regularly support this perso with everyday tasks (on a weekly/bi-weekly basis), such as helping them at home, running errands, companionship, taking them to appointments? Choose one of the following answers Yes No (This question is mandatory) How many years ago were you/they diagnosed with a vision impairment? (This question is mandatory) Have you or the person you provide care support to been diagnosed with any of the following conditions? Choose one of the following answers Wet age-related macular disease (wet AMD) Dry age-related macular disease (dry AMD) Diabetic macular oedema (DMO) Other macular condition not specified above None of the above Other: Please can you list any organisations that you have heard of that provide help and support to people with low vision or sight conditions: (This question is mandatory) Have you, or the person you provide support to, ever used any of the Macular Society services (e.g local support groups, telephone counselling services)? Choose one of the following answers Yes No (This question is mandatory) How many times have you, or the person you provide support to, accessed the Macular Society website in the past year? (This question is mandatory) How comfortable are you, or the person you provide support to, with using the internet to search for information on a scale of 1 to 5, where 1 = not at all comfortable and 5 = extremely comfortable? Choose one of the following answers 1 2 3 4 5 (This question is mandatory) How would you describe your ethnicity? (This question is mandatory) Please select how you would prefer to contribute to the research. You can select online survey and telephone interview if you are happy to contribute in either way: Check all that apply Online Survey (20 minutes) Telephone Interview (20 minutes) Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×