Shanghai Daily 2021 "Living a Healthy Life" Eye Health Survey

1. How old is your child? (Single choice) 您孩子的年龄?（单选）

2. What’s the gender of your child? (Single choice) 您孩子的性别?（单选）

3. Has your child ever suffered from the following eye disease or related symptoms? (Multiple choices) 您的孩子是否有过以下眼部疾病或相关症状?（多选）

4. Have you taken any preventive measures against the following eye disease or related symptoms? (Multiple choices) 您对上述哪些眼部疾病采取过预防措施，或进行过早期干预？（多选）

5. If you have any other questions about eye health of adolescents and children, please fill in the blank below. 若您有其他想了解的关于青少年儿童用眼健康的问题，请在下面留言。