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Have you or a loved one taken Elmiron?
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Have you experienced serious vision impairment after taking Elmiron?
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Yes
No
Were you diagnosed with any of the following?
*
Pigmentation Maculopathy
Age-related Macular Degeneration (AMD)
Other retinal disease or eye damage
Other diagnosis
No diagnosis
Have you experienced any of the following symptoms?
*
Blindness
Vision Loss
Blurry vision, difficulty reading
Other eye injury
No symptoms
Estimate how long you took Elmiron
*
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Between 1 and 2 years
Between 3 months and 1 year
Less than 3 months
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