Self Test For Cataracts In ReadingBerks Eye Physicians & Surgeons, Ltd. Name: * Email: * Phone: * If you think you might have cataracts, you may complete the following form and submit it to us. We will contact you to schedule a comprehensive cataract evaluation.1. I am having trouble with:* Painless blurring of vision Hazy, Cloudy vision Sensitivity to light and glare Double vision in one eye Poor night vision Fading or yellowing of colors Frequent changes in glasses or contact lens prescription 2. I would like to reduce or eliminate my need for spectacles or contact lenses: Yes No