Leber's Hereditary Optic Neuropathy

LHON Web Survey version 2.02 last updated on 14 May 2003

You can help build a picture of LHON around the world.

Some of the questions asked about LHON can only be answered by you. Such questions as "What jobs can someone with LHON do?". "What hobbies can someone with LHON have?" or "What aids help someone with LHON?".

This form will send your information to me by e-mail. I will then use this to add general information on the education, jobs and hobbies of people affected by LHON to the Frequently Asked Question (FAQ) area. The survey responses will not be used for any other purpose and will not be passed on to any other person or organisation.



There are no 'mandatory' questions.
You can give name and e-mail information if you wish, but this will not be used for the survey.
Your location and country will only be used to show how many responses came from that place.

All of the questions below should be answered with information for a person affected by LHON


Sex

LHON Gene





What age is the affected person now?
Age




What age was he or she when LHON first started?
Onset Age



Please select your current job or occupation
Jobs


Did your job or occupation change as a result of LHON?
Job change



Please select your main pastimes or hobbies
Hobbies


Magnifiers


Computer adaptation


White Cane Use


Guide Dog Use


Braille Use




Thank you for completing this form.

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