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(Kindly fill in the relevant information or tick, as appropriate.)

  1. As per your clinical practice, what is the approximate number of patients diagnosed with Dry eye disease (DED) every month?

  2. As per your clinical practice, which is the most common age group in patients diagnosed with Dry eye disease (DED)?

  3. As per your clinical practice, kindly provide the approximate break-up of patients with Dry eye disease on the basis of duration of diagnosis?

    4. A.  < 15 days

    %

    B.  16 days to < 1 month

    %

    C.  >1 month to < 3 months

    %

    D.  > 3 months

    %

    Total

    		 100%
  4. As per your clinical practice, which is the most common causes in patients diagnosed with Dry eye disease (DED), as observed in your practice?

    (Tick all applicable)

  5. As per your clinical practice, kindly provide the approximate break-up of patients with Dry eye disease on the basis of dry eye disease type?
    6. %
    %
    %
    %

    Total

    		 100%
  6. What is the approximate percentage of dry eye disease patients with co-morbidities, as per observations in your practice?

    (Please tick the applicable option)

  7. Kindly rank the most common co-morbidities observed in Dry eye disease patients as per your practice?
    (Please rank from rank 1 to rank 5 as from most common to least common comorbidity)
    8. Rank
    Rank
    Rank
    Rank
    Rank
  8. As per your clinical practice, which are the most common symptoms in patients diagnosed with Dry eye disease (DED), as observed in your practice?
    (Please tick the applicable option)

  9. How frequently are the patients with dry eye disease required to follow-up ?
    (Please tick the applicable options)
  10. What is the approximate percentage of patients with dry eye disease requiring artificial tear formulations, as per your practice?

  11. As per your clinical practice, kindly rank your preferred tear substitutes/ ocular lubricants in patients diagnosed with dry eye disease?
    (Kindly specify the rankings in front of each agent as per your preference)
  12. What is the approximate percentage of patients diagnosed with dry eye disease requiring Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel as per your practice?

  13. As per your practice, what is the approximate percentage of below mentioned patients might have complaints of dry eye disease?
    (Please tick the applicable option for each of the conditions)
    14. 1-5% 5-10% 10-30% 30-50% More than 50%
  14. As per your practice, what is the preferred treatment option for below mentioned patients with complaints of dry eye disease?
    (Please tick the applicable option for each of the conditions)
    15. Cellulose based Dextran based Gelatin based Polyethylene glycol based Any other
  15. As per your practice, what is the appropriate reasons for prescribing Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel treatment option in your patients for below mentioned patients with complaints of dry eye disease?
    (Please tick the applicable option for each of the conditions)
    16. Better symptomatic relief Better improvement in clinical signs Improvement in vision quality Cost/availability Any other
  16. As per your clinical practice, does your treatment option varies according to the below mentioned parameters in patients diagnosed with Dry eye disease (DED) ?
    (Please specify yes or No)
    17. Yes No
  17. For which of the following complaints, as per your practice require Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel?

  18. As per your clinical practice, kindly provide the approximate break-up of use of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in different categories of Dry eye disease patients on the basis of severity?
    19. %
    %
    %

    Total

    		 100%
  19. As per your clinical practice, kindly provide the approximate break-up of usage of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in percentages for the frequency of administration advised?
    (Please tick the applicable option)
    20. %
    %
    %
    %

    Total

    		 100%
  20. How would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in providing relief from dry eye discomfort?
    (Please tick the applicable option)
  21. What is the advantage of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel over other treatment options as per observations in your practice?

  22. What is the average duration of therapy advised for Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel as per your practice?

  23. How would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in providing relief in terms of improvement of soreness/irritation?
    (Please tick the applicable option)
  24. How would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in providing relief in terms of symptom control of dryness?
    (Please tick the applicable option)
  25. Any other medication which you use concomitantly with of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in patients with dry eye disease?

  26. How would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in providing relief in terms of improvement of eye fatigue?
    (Please tick the applicable option)
  27. How would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in providing relief in terms of improvement of burning sensation in patients with dry eye disease?
    (Please tick the applicable option)
  28. How would you rate Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in terms of compliance in patients with dry eye disease?
    (Please tick the applicable option)
  29. As per your clinical practice, kindly specify the other class of drug given along with Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in patients with dry eye disease?
    (Please tick all the applicable options)
  30. As per your practice, how would you rate the efficacy of Hydroxypropyl methylcellulose (Hypromellose) ophthalmic gel in your patients for below mentioned patients with complaints of dry eye disease?
    (Please tick the applicable option for each of the conditions)
    Strongly recommended Recommended Neutral Not recommended