| Not at all | A little | Moderately | Extremely |
1) How your eyelid scars look (obvious, noticeable, uneven)? | 1 | 2 | 3 | 4 |
2) Dry eyes? | 1 | 2 | 3 | 4 |
3) Eye irritation (e.g. redness, itching)? | 1 | 2 | 3 | 4 |
4) Excessive tearing? | 1 | 2 | 3 | 4 |
5) Your eyes looking hollowed out? | 1 | 2 | 3 | 4 |
6) Difficulty closing your eyes? | 1 | 2 | 3 | 4 |