Questions: Click the checkbox for yes

Are you under 40 years old

Are you 50 to 59 years old

Are you 60 to 75 years old

Are you 75 to 79 years old

Are you over 80 years old

Have your biological father or grandparents on your father’s side lived between 65 and 70 years before passing away

Have your biological father or grandparents on your father’s side lived beyond the age of 80

Have your biological mother or grandparents on your mother’s side lived between 65 and 70 years before passing away

Have your biological mother or grandparents on your mother’s side lived beyond the age of 80

Did your biological mother have AMD (macular degeneration)

Did your biological father have AMD

Do you have a biological sibling with AMD

Do you have any direct biological relatives (aunts, uncles, etc.) with AMD

Are you male

Are you female

If you are female did you experience early menopause

If you are female do you take hormone replacement therapy

Have you spent a lot of time outdoors in bright sun over your lifetime (Average of 5 hours per day)

Are you overweight, considered obese and have a high body mass index (30% above normal weight for age and sex)

If you are male have you smoked in the last 15 years

If you are male did you smoke for more than 40 years

If you are female have you smoked in the last 15 years

If you are female have you smoked more than 40 years

If you smoke and have not answered any of the above questions check yes here

Are you a light drinker (one glass of alcohol per day or less)

Are you a heavy drinker

Are you a non-drinker

Do you have high Blood Pressure for which you take medication

Do you have high Blood Pressure but do not take medication (more than 160/95)

Are you Caucasian (white) or of Northern European Heritage

Do you live in America, Australia, or the Netherlands

Are you of Hispanic Heritage

Are you of Asian Heritage

Are you of African Heritage

Do you have Blue eyes

Do you have Grey eyes

Do you have Green / Hazel eyes

Do you have Violet eyes

Do you have Brown eyes

Do you have Red eyes

Do you have eyes of mixed colors

Do you take vitamin supplements containing Lutein or Zeaxanthin

Do you eat green leaf vegetables on a daily basis

Do you eat red meats once or more a day

Do you eat fish on a regular basis (3 -4 time per week)

Do you exercise on a daily basis

Do you have blurred vision

Have you ever noticed a blind spot in your central vision

Do you notice a black spot in your central vision in one or both eyes

Do you look to the sides of you eyes to see clearly

Do you have hazy vision

Has a doctor ever told you your eyes have “drusen”

Have you had Cataract Surgery

Have you had diabetes for more than 5 years

Have you had diabetes for more than 20 years

Do you have Glaucoma in your biological family

Do you have Glaucoma currently

Do you have Cataracts currently

Do you have Retinitis Pigmentosa

Have you ever had genetic testing and been told you have variants of Factor H (CFH GENE) and Factor B, or the SERPING1 gene

If you have had a blood test did your doctor tell you that you have markers: C-reactive protein (CRP) and interleukin 6 (IL-6)

Are you color blind

Do you have trouble matching clothing colors when you dress

Do you have trouble reading print of different sizes

Have you ever noticed print, telephone poles, floor tile are wavy

Have you ever noticed that you see glare when indoors and outdoors

Do you have a regular (two years or less) eye exam

WHEN FINISHED CLICK BELOW