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Data Collection Form

(To be filled only by physician)

A multicentric, cross-sectional, observational survey study to understand the role of 0.18% sodium hyaluronate and trehalose eye drops in management of dry eye disease


  1. 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) *
  2. What is the approximate percentage of patients with dry eye disease requiring artificial tear formulations, as per your practice? *
  3. What is the approximate percentage of patients diagnosed with dry eye disease requiring 0.18% sodium hyaluronate and trehalose eye drops as per your practice? *
  4. 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) *
  5. 1-5% 5-10% 10-30% 30-50% More than 50%



  6. As per your practice, what is the appropriate reasons for prescribing 0.18% sodium hyaluronate and trehalose eye drops 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) *
  7. Better symptomatic relief Better improvement in clinical signs Improvement in vision quality Cost / availability Any other



  8. For which of the following complaints, as per your practice require 0.18% sodium hyaluronate and trehalose eye drops? *
  9. What is the average duration of therapy advised for 0.18% sodium hyaluronate and trehalose eye drops as per your practice? *
  10. Any other medication which you use concomitantly with of 0.18% sodium hyaluronate and trehalose eye drops in patients with dry eye disease? *
  11. As per your clinical practice, kindly specify the other class of drug given along with 0.18% sodium hyaluronate and trehalose eye drops in patients with dry eye disease? (Please tick all the applicable options) *
  12. As per your practice, how would you rate the efficacy of 0.18% sodium hyaluronate and trehalose eye drops in your patients for below mentioned patients with complaints of dry eye disease? (Please tick the applicable option for each of the conditions) *
  13. Strongly recommended Recommended Neutral Not recommended