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