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ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.4
,
No
.2
,
Jun
e
2
015
, pp
. 11
3
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11
8
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S
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: 225
2-8
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6
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urn
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o
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: h
ttp
://iaesjo
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r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Risk Factors of Low Visi
on in Children
Tiur D
i
ana
w
at
i, Liena So
f
i
ana
Faculty
of Public Health
Scien
c
e, Univ
ersitas Ah
mad Dahlan
, Yo
g
y
ak
arta, Indonesia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received Feb 05, 2015
Rev
i
sed
Mar
c
h 25
,
20
15
Accepted Apr 27, 2015
Low vision and blindness is a vision di
sorder that becomes an importan
t
issue with r
e
gar
d
to
a p
e
rson'
s
in
dependen
c
e. According
to d
a
ta o
w
ned b
y
th
e
World Health Organization in 2
011, th
e number
of blind people
in the world
reach
ed 39 m
illi
on, 246 m
illion for low vision an
d 285
m
illion for blindness.
The purpose of
this stud
y
was
to know the inciden
ce of
risk factors
in
childr
e
n with lo
w vision in Low Vision Service
Center Pertun
i
Yog
y
ak
arta
,
Indonesia.
This stud
y
was an o
b
serva
tion
a
l an
aly
tic stud
y
emplo
y
ed
cross
section
a
l design
. The subj
ec
t p
a
rti
c
ipa
t
ed in
th
is stud
y
was 13
9 childr
e
n.
Data were an
al
yz
ed us
ing corr
ela
tion ana
l
y
s
is
.
The ins
t
rum
e
nt us
ed was
check l
i
s
t
. The
r
e were rel
a
tio
ns
hips
between
the sex with low vision
(p=0.028, RR=1
.
308), there was no relatio
nship between regu
lar ey
e ch
ecku
p
with low vision
incid
e
nce (p
=0
.801,
RR
=1.054
). Th
ere was r
e
lationship
between
the use of vision aids with low vision (p=0.000, RR
=0
.640), th
er
e
was a relation
ship between
the catar
act w
ith low vision
(p=0.000,
RR=1.472), th
er
e was
a co
rrelation betwee
n the refractiv
e
disord
erwith low
vision (p=0
.000
, RR=0
.
625).Th
e
re should b
e
an aw
areness
of health
behaviours in
the use of v
i
sio
n
aids as n
eed
ed and b
a
lanced diet with
s
u
fficien
t
ph
ys
ic
al act
ivit
y and
re
gular.
Keyword:
Cataract
Glauc
o
m
a
Lo
w Visi
on
Per
i
od
ic Eye C
h
eckup
Visual Aids
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Liena Sofia
n
a,
Facu
lty of Public Health
,
Uni
v
erasitas Ahm
a
d
Dahla
n
,
Jl
n.
P
r
of So
ep
o
m
o,
Jant
ura
n
,
War
u
ng
b
o
t
o
,
Yo
gy
aka
r
t
a
, In
do
nesi
a.
Em
ai
l
:
l
i
e
na.sof
ana@i
k
m
.
uad.
ac.i
d
1.
INTRODUCTION
Si
ght
i
s
o
n
e v
e
ry
im
port
a
nt
fact
or i
n
al
l
aspect
s of l
i
f
e i
n
cl
udi
n
g
t
h
e e
d
ucat
i
onal
pr
oc
ess and t
h
e
main
in
form
ati
o
n
po
in
t; h
e
n
c
e th
e d
e
lay to
mak
e
co
rrection
s
, esp
ecially in
ch
ildren
of sch
o
o
l
age will g
r
eatly
affect th
e ab
ility to
ab
sorb
t
h
e learn
i
ng
m
a
t
e
rial a
n
d
redu
ced
th
e
p
o
t
en
tial to
in
crease intellig
en
ce. Alt
h
oug
h
t
h
e f
u
n
c
t
i
o
n
o
f
hum
an l
i
f
e i
s
v
e
ry
i
m
port
a
nt
,
but
oft
e
n
ove
rl
oo
ke
d ey
e
heal
t
h
, s
o
m
a
ny
di
s
eases t
h
at
at
t
ack t
h
e
eye is no
t treat
ed
p
r
op
erly and
cau
s
e
v
i
sion
p
r
ob
lem
s
u
n
til b
lin
dn
ess [1
].
B
a
sed o
n
t
h
e sur
v
ey
resul
t
s
S
e
nse o
f
Si
ght
a
nd
Heari
n
g i
n
19
9
3
-
1
99
6 t
h
e pre
v
al
ence
of
bl
i
n
d
n
ess i
n
In
d
onesi
a am
ount
e
d
t
o
1
.
5
%
wi
t
h
t
h
e m
a
in cause
s of c
a
t
a
ract
(0.
7
8%
), gl
a
u
com
a
(0.
2
0
%
), i
n
ci
de
nce o
f
in
cid
e
n
c
e of refractiv
e
d
i
sord
er(0.14
%
), retin
al ab
no
rm
al
ities (0
.13
%
),
co
rn
eal abno
rmali
ties (0
.10%), and
ot
he
r cau
ses
(
0
.
1
5
%
).
Lo
w
vi
si
o
n
an
d
bl
i
n
d
n
ess
i
s
a vi
s
i
on
di
so
r
d
er t
h
at
becom
e
s an
im
port
a
nt
i
ssue
wi
t
h
rega
rd t
o
a
pe
rso
n
'
s
i
nde
pen
d
ence
. Acc
o
r
d
i
ng t
o
d
a
t
a
ow
ned
by
t
h
e
WHO i
n
20
1
1
, t
h
e n
u
m
b
ers of
bl
i
n
d
people
in
the world reached 39
m
ill
ion people, low vision and
reach
246
m
i
l
lion people who are
blind to 285
m
i
ll
i
on o
f
s
o
ul
[2]
.
In
d
onesi
a
does
not
ha
ve b
a
sel
i
n
e dat
a
o
n
t
h
e
pre
v
al
ence
of
l
o
w vi
si
on
whi
c
h co
ver
s
al
l
the t
e
rri
t
o
ry
.
Resu
lts of
H
e
alth
Resear
ch
in D
I
Y
on
20
07
, th
e
o
v
e
r
a
ll pro
por
tio
n of
the po
pu
latio
n aged
6
year
s and
ab
ov
e
i
n
t
h
e a
r
ea o
f
DI
Y
wh
o
have
l
o
w
vi
si
o
n
a
n
d bl
i
n
d
n
ess
of
6.
3% at
0
.
9
%
.
The
hi
g
h
est
i
n
ci
dence
of
l
o
w
vi
si
o
n
is in
Gunu
ng
Kid
u
l
d
i
strict,
b
u
t th
e lowest is i
n
Slem
an
[3
].
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
11
3 – 1
1
8
11
4
Low
Vision Se
rvice Ce
nter
Pertun
i Yogyakarta (PLLVP) is a
place
of t
h
e
pe
ople
who
have
built
up
a referral system with
lo
w
v
i
sio
n
serv
ices in
co
llabora
tio
n with
ho
sp
itals, schoo
ls and
g
o
v
e
rn
m
e
n
t
agen
cies
co
n
c
ern
e
d, the scop
e of activ
ities in
clu
d
e
screen
i
n
g,
co
un
seling
,
clin
ical an
d
fu
n
c
tion
a
l ex
amin
atio
n
,
evaluation and training
for teachers a
n
d
hea
lth staff. Data from
the Cent
er for L
o
w
Vis
i
on Se
rvices Pertuni
Yog
y
ak
arta, stated
th
at sin
ce th
e year 1
9
9
9
-201
2
h
a
s b
e
en
prov
id
i
n
g
care and
reh
a
b
ilitatio
n
to
2
,
6
18 p
e
op
l
e
wh
o
have i
m
pai
r
ed vi
si
on
d
u
e
t
o
l
o
w
vi
si
o
n
.
C
o
n
s
i
d
eri
ng t
h
e hi
gh
n
u
m
b
er o
f
pe
o
p
l
e
wi
t
h
l
o
w vi
si
o
n
b
o
t
h
i
n
childre
n a
n
d
old age
,
the re
s
earche
r
s a
r
e i
n
terested in
doing
researc
h
on the i
n
cide
nce of ris
k
fact
ors
in
ch
ild
ren
with
l
o
w v
i
si
o
n
in
PLLVP Yog
y
akarta.
Th
e d
e
fin
ition
o
f
low
v
i
sio
n
acco
rd
ing
to
th
e
W
H
O
in
1
992, b
a
sed
on
th
e fu
n
c
tion
a
l d
e
finitio
n
is: "A
p
e
rson
who
has a v
i
su
al
fun
c
tio
n
abn
o
rmalities, ev
en
after treatm
e
n
t
, su
ch
as surgery and
/ o
r
stan
d
a
rd
ref
r
act
i
v
e c
o
r
r
ect
i
on (
s
pect
ac
l
e
s or c
o
nt
act
l
e
nses)
,
vi
s
u
al
acui
t
y
<6/
1
8
- l
i
ght
perce
p
t
i
on a
n
d
br
oa
d
vi
si
o
n
<1
0
d
e
grees fro
m
th
e fix
a
tion
po
in
t, bu
t h
e
was still
ab
le
o
r
lik
ely to
b
e
ab
le to
u
s
e th
eir v
i
sio
n
to
p
l
an
or
carry
o
u
t
an
activ
ity / wo
rk
"
[4
].
Peop
le with
low v
i
sion
h
a
v
e
sp
ecial
ch
aract
eristics, d
i
fferen
t
fro
m
th
e v
i
su
ally d
i
sab
l
ed
p
e
op
le with
b
lin
d cond
itio
ns. Lo
w v
i
sion
i
s
no
t th
e sam
e
as b
lind
as p
e
op
le with low
v
i
sio
n
ju
st lo
st m
o
st of
h
i
s sigh
t, and
still h
a
v
e
so
me u
s
ab
le
v
i
sion. Th
e co
mm
o
n
traits th
at ar
e o
f
ten
seen
i
n
peo
p
l
e
with
low v
i
sio
n
, wh
ich
is to
wri
t
e
o
r
rea
d
a
sho
r
t
di
st
a
n
ce
, can
onl
y
rea
d
l
a
rge l
e
t
t
e
rs, s
qui
nt
i
ng
o
r
f
r
o
w
ni
ng
w
h
en
vi
ewi
n
g u
n
d
er
b
r
i
g
ht
l
i
ght
, l
o
o
k
s
d
o
n
o
t
st
are
st
rai
ght
ahea
d
w
h
e
n
l
o
o
k
i
n
g s
o
m
e
t
h
i
n
g
.
T
h
e ey
e
s
l
o
ok
di
ffe
ren
t
, f
o
r
exam
pl
e, w
h
i
t
e
in the eyes
(cat
aract)
or clear
pa
rt i
n
front
of
the eyes look fo
gg
y
(
p
r
o
b
l
ems on
t
h
e co
rn
ea)
[5
].
In
itial ex
am
in
atio
n
s
of p
a
tien
t
s with
low visio
n
ar
e
b
a
sically th
e sa
m
e
as for th
e ex
amin
atio
n
of
o
t
h
e
r p
a
tien
t
s,
alth
o
ugh
it can
b
e
a
b
it m
o
re p
r
ob
lem
a
tic.
Ex
am
in
atio
n
for p
a
tien
t
s
wi
th
lo
w
v
i
sion
can
be
very
t
i
r
i
n
g
bec
a
use i
t
i
s
do
ne
wi
t
h
a
co
u
p
l
e
of
vi
si
t
s
a
n
d
o
n
e-t
i
m
e checks
sh
oul
d
be
n
o
m
o
re t
h
an
o
n
e
h
o
u
r
.
Exam
i
n
at
i
on r
e
qui
res ge
nera
l
case hi
st
ory
,
t
oget
h
e
r
wi
t
h
a
caref
ul
hi
st
or
y
,
m
easuri
n
g t
h
e si
ze of t
h
e gl
asse
s
are use
d
and aids othe
r optical,
m
eas
uri
ng t
h
e di
st
ance a
n
d near
vi
sual
a
c
u
ity b
e
fore / after correction
,
th
e
su
bj
ectiv
e ex
amin
atio
n
,
co
lor v
i
sion
, con
t
rast sen
s
itiv
ity, v
i
su
al field,
wh
at
ev
er p
e
rceiv
e
d
n
eed.
In t
h
e sec
o
nd
vi
si
t
,
m
o
re use
d
t
o
pe
rf
o
r
m
preci
se det
e
rm
i
n
at
i
on o
f
refract
i
o
n,
v
i
sual
fi
el
d
ex
am
in
atio
n
an
d ex
am
in
atio
n
o
f
v
i
su
al acu
ity exp
a
nd
ed
m
o
re
fu
lly. Far v
i
su
al acu
ity ex
am
in
atio
n
is
gene
ral
l
y
perf
orm
e
d at
a di
st
ance of
6 m
e
t
e
rs. Acc
o
r
d
i
n
g C
o
l
e
n
b
r
a
n
d
e
r
exam
i
n
at
i
on vi
sual
acui
t
y
i
n
l
o
w
vi
si
o
n
i
s
m
o
st
ly
done at
a di
st
ance of 3 m
e
t
e
rs. The cl
os
er t
h
e ob
ject
, t
h
e bet
t
e
r t
h
e o
b
ject
i
s
vi
si
bl
e
;
t
h
e
vision should
be checke
d
at
a distan
ce
whe
r
e the
patient c
a
n see,
not at a distance
of
6
meters. If t
h
e
patient
can rec
o
gnize the letters at a d
i
stance of 6 m
e
ters, she ha
s a visual acuity 6/60. If th
e pati
ent can only see at a
di
st
ance
of
3
m
e
t
e
rs t
h
e
n
be
3/
60
o
r
vi
sual
ac
ui
t
y
6/
1
2
0
[
6
]
.
On cl
ose exa
m
ination of visual acuity to note
is the s
i
ze of the font and s
p
acing read. M
o
st
p
r
actitio
n
e
rs
reco
mmen
d
to
ch
eck all th
e
ab
ility to
read at a stand
a
rd d
i
stan
ce is
40
cm
. Fo
r low v
i
sion
exam
ination, the exam
ination distanc
e
rem
a
i
n
s ve
ry
i
n
ap
pr
o
p
ri
at
e, beca
use t
h
e l
o
w
vi
si
on
pat
i
e
nt
re
qui
res
a
m
u
ch
sho
r
ter distan
ce th
an
p
a
tien
t
s with
v
i
si
o
n
norm
a
l [6
].
On
t
h
e t
h
i
r
d
vi
si
t
,
i
n
st
r
u
m
e
nt
ai
ds
can
b
e
t
r
i
e
d.
Acc
o
r
d
i
n
g t
o
T
r
oy
E Fa
ni
n a
n
d
The
o
d
o
re
P
Gr
os
ven
o
r
st
re
ssed t
h
at
"
opt
i
cal
ai
ds are
d
e
si
gne
d f
o
r pa
t
i
e
nt
s wh
o
ha
ve l
o
w vi
si
on
di
ffe
re
nt
fr
om
t
hose
designe
d
for other
patients
because its
pri
m
ary purpose
is to provi
d
e e
n
largem
ent
with or without
c
h
anging
t
h
e beam
conv
erge
nce
dat
i
ng
[7]
.
The e
n
large
m
ent above is
to
increase t
h
e
size of the
sh
ad
ow
o
f
the retin
a
of
th
e obj
ect b
e
i
n
g
v
i
ewed
,
b
ecau
s
e
b
y
in
creasi
n
g th
e sh
ad
ow
s on
th
e retin
a
it will b
e
fo
llowed b
y
an
i
n
crease in
vi
sual
ac
ui
t
y
.
Opt
i
cal
ai
ds
f
o
r fa
r
vi
si
o
n
sy
s
t
em
i
s
used i
n
t
h
e
fo
rm
t
e
l
e
scope
m
ount
ed
o
n
a
fram
e
gl
ass
e
s an
d
hel
d
h
a
n
d
s. T
h
e ai
ds req
u
i
r
e
d
for
near
vi
si
o
n
o
p
t
i
cal
ai
ds such as M
a
gni
f
y
i
ng Gl
asses
,
M
a
gni
fi
e
r
an
d C
l
ose-
C
i
rcui
t
Tel
e
vi
s
i
on/
C
C
T
V
[
7
]
.
Som
e
of t
h
e fa
ct
ors rel
a
t
e
d w
i
t
h
t
h
e occ
u
r
r
e
n
ce o
f
l
o
w vi
si
on i
n
chi
l
d
ren
i
n
cl
ude s
o
ci
o
d
e
m
ogra
p
hi
c
factors that inc
l
ude a
g
e,
gender, race a
n
d ge
netics and heal
th be
havi
ors
.
Othe
r factors a
r
e also ass
o
ciated with
th
e o
c
curren
c
e of low
v
i
sion is th
e
presen
ce of
o
t
h
e
r com
o
rb
id
ities, bo
th
syste
m
ical
ly an
d in
t
h
e
an
terior
segm
ent of t
h
e
eye suc
h
as a
history of catar
a
c
t
,
an
d
hi
st
ory
of
re
fract
i
v
e
di
sor
d
e
r
[
8
]
.
2.
R
E
SEARC
H M
ETHOD
This type
of
re
search usedquantita
tive m
e
thods
with the
type
of cros
s
sec
tional
design, the aim
s
of
th
is stu
d
y
t
o
determin
e th
e relatio
n
s
h
i
p
b
e
t
w
een
cataract
, incide
nce of refractive
di
sorder,
the use of
visua
l
ai
ds and
peri
odi
c ey
e chec
ku
p wi
t
h
eve
n
t
s
at
C
h
i
l
d
ren'
s Low Vi
si
on i
n
L
o
w V
i
si
on Ser
v
i
ce C
e
nt
r
e
Per
t
un
iYog
yakar
t
a. Th
e sub
j
ects o
f
th
is study w
e
r
e
13
9
child
r
e
n. Th
e
d
a
ta u
s
ed
i
n
th
is stu
d
y
w
e
r
e
pr
i
m
ar
y
d
a
ta tak
e
n
d
i
rectly fro
m
th
e research
subj
ects co
up
le
d
wi
t
h
sec
o
n
d
ary
d
a
t
a
on
get
f
r
o
m
t
h
e obse
r
vat
i
on a
n
d
d
o
c
u
m
en
tatio
n. Th
e in
st
ru
m
e
n
t
used in
t
h
is
stu
d
y
was a check
list fo
r th
e
o
b
s
erv
a
tio
n sheet.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Risk Fact
ors
of
Low
Vision
in Ch
ild
ren
(Tiu
r Dian
a
w
a
ti)
11
5
Uni
v
ari
a
t
e
ana
l
y
s
i
s
em
pl
oy
ed t
o
e
x
pl
ai
n
o
r
desc
ribe
the
characte
r
istics of eac
h
varia
b
le. Bivariate
an
alysis was co
ndu
cted
t
o
d
e
termin
e th
e rel
a
tio
n
s
h
i
p
o
f
each
v
a
riab
le on
th
e low
v
i
sio
n
research
. M
u
ltiv
ariate
an
alysis to
d
e
t
e
rm
in
e wh
ich
v
a
riab
le are mo
st influ
e
n
tial o
ccurren
ce
of l
o
w v
i
si
o
n
.
3.
R
E
SU
LTS AN
D ANA
LY
SIS
3.
1.
Descripti
v
e Analysis
Resu
lts of un
i
v
ariate an
alysis are sho
w
n
in Tab
l
e
1
.
Ta
bl
e 1 s
h
ows
that
there is
no di
fference i
n
the
num
ber o
f
sam
p
l
e
s i
n
t
h
i
s
st
udy
base
d o
n
gen
d
e
r
beca
us
e the average i
s
alm
o
st
the sa
m
e
, whereas
by age
m
o
r
e
is th
e age gr
oup
o
f
7-
12
year
s in
t
h
e stu
d
y
sam
p
le. Based
on
th
e statu
s
o
f
l
o
w v
i
si
o
n
ar
e fo
und
su
bj
ect
s
wh
o s
u
ffe
r f
r
o
m
l
o
w
vi
si
o
n
a
s
m
a
ny
as 10
4
chi
l
d
re
n
(7
4.
8
%
).
Tabl
e
1. C
h
ara
c
t
e
ri
st
i
c
s of
res
p
o
n
d
ent
s
i
n
ci
d
e
nce
of
l
o
w
vi
si
on i
n
c
h
i
l
d
re
n
Charact
erist
ic
Am
ou
n
t
Presentage
(
%
)
Age
1-
6 y
ear
s
old
33
23.
8
7-
12 y
ear
s old
69
49.
6
12-
18 y
ear
s old
37
26.
6
Sex
M
a
le 71
51.
1
Fem
a
le 68
48.
9
Use of
aid sight
Do not use
90
64.
7
W
e
ar
49
35.
3
Periodic exa
m
ina
t
ion
No per
i
odic
38
27.
3
Per
i
odic
101
72.
7
Chat
aract
Chataract
45
32.4
No chataract
94
67.6
Refractive disord
er
Refr
active disor
d
er
82
59.
0
No r
e
fr
ative disor
d
er
57
41.
0
Am
ou
nt
139
100
Acco
r
d
i
n
g t
o
t
h
e hi
st
o
r
y
of t
h
e use
of
vi
su
al
ai
ds
, in this case that doe
s not use
visual aids
m
o
st
resp
o
nde
nt
s us
e vi
sual
ai
ds, whi
l
e
base
d o
n
peri
o
d
i
c
i
n
spe
c
t
i
on fo
u
nd t
h
a
t
t
h
e
m
a
jori
t
y
of res
p
on
de
nt
s
do n
o
t
per
f
o
r
m
peri
o
d
i
c
i
n
spe
c
t
i
o
n
s
. B
a
sed
on t
h
e di
a
g
n
o
si
s
of t
h
e
di
sease
i
s
fou
n
d
m
o
st
resp
on
de
nt
s di
d
not
cat
aract
an
d m
o
st
re
sp
o
nde
nt
s ha
d a
hi
st
o
r
y
of
re
fract
i
v
e
di
sor
d
e
r
.
3.
2.
B
i
vari
a
te An
a
l
ysi
s
Bivariate analy
zes we
re c
o
nducted on t
w
o
vari
ables e
x
pected t
o
rela
te
or correlated [9].
In th
is st
ud
y
bi
va
ri
at
e anal
y
s
i
s
was con
duct
e
d t
o
det
e
rm
i
n
e t
h
e rel
a
t
i
onshi
p of
t
h
e i
nde
pen
d
e
n
t
vari
a
b
l
e
s wi
t
h
t
h
e
in
cid
e
n
c
e
o
f
l
o
w
v
i
sion
. Th
e
statistica
l
test u
s
ed
is C
h
i sq
u
a
re.
Tabl
e
2. R
e
l
a
t
i
ons
hi
p B
e
t
w
ee
n R
i
sk
Fact
o
r
s
W
i
t
h
L
o
w
Vi
si
on
Variable
St
at
us of
Low
Vision
Total RR
Sig
Lo
w
vision
Norm
al
Sex
M
a
le 56
40.
3
15
10.
8
71
51.
1
1.
308
0.
028
Fem
a
le 41
29.
5
27
19.
4
68
48.
9
(
1
.
042-
1.
642)
Used vision aid
Do not use
55
41.
0
35
25.
2
90
64.
7
1.
403
0.
005
W
e
ar
42
30.
2
7
5.
0
49
35.
3
(
1
.
148-
1.
714)
Periodic eye exa
m
i
n
ation
No per
i
odic
28
20.
1
10
7.
2
38
27.
3
0.
927
0.
684
Per
i
odic
69
49.
6
32
23.
0
101
72.
7
(
0
.
735-
1.
169)
Chataract
Chatar
act
43
30.
9
2
1.
4
45
32.
4
1.
663
0.
000
No chatar
act
54
38.
8
40
28.
8
94
67.
6
(
1
.
382-
2.
001)
Ref
r
active disorder
Refr
active disor
d
er
42
30.
2
40
28.
8
82
59.
0
0.
531
0.
000
No r
e
fr
active disorder
55
39.
6
2
1.
4
57
41.
0
(
0
.
427-
0.
659)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
11
3 – 1
1
8
11
6
Table
2 s
h
ows
that the
factors associ
at
ed
wi
t
h
t
h
e i
n
ci
de
nc
e of
l
o
w
vi
si
on
i
s
sex
wi
t
h
si
g
.
o
f
0.
02
8,
t
h
e use o
f
vi
si
on ai
ds
wi
t
h
si
g. o
f
0.
0
0
0
,
a hi
st
ory
o
f
cat
aract
wi
t
h
si
g.
of 0
.
0
0
0
an
d r
e
fract
i
v
e di
s
o
r
d
er
wi
t
h
si
g.
of
0
.
0
0
0
.
Fact
or
t
h
at
ha
d
no
ass
o
ci
at
i
on
wi
t
h
t
h
e
i
n
ci
dence
o
f
l
o
w
vi
si
o
n
i
s
peri
o
d
i
c
ey
e ch
eck
u
p
(si
g
.
0.
80
1
)
.
3.
3.
An
al
ysi
s
of
M
u
l
t
i
v
ari
a
te
Tab
l
e 3
illu
strates th
at th
e facto
r
s m
o
st in
flu
e
n
tial o
ccu
rren
ce
o
f
low
v
i
sion
is refractiv
e d
i
sord
er
w
ith
si
g
=
0.000.
Tab
l
e
3
.
Resu
l
t
s o
f
Mu
ltiv
ari
a
te An
alysis
Variable Koef.
S.E
Wald
df
P
value
OR
CI 95%
Min Max
Ref
r
active disorder
Constanta
3.
219
-
2
.
921
0.
756
0.
744
18.
126
15.
410
1
1
0.
000
0.
000
24.
99
0.
05
5.
68
110.
01
4.
DIS
C
USSI
ON
4.
1.
Rel
a
ti
ons
h
i
p
Sex w
i
th
L
o
w
Vi
si
on
From
t
h
e resea
r
ch
o
n
1
3
9
res
p
o
n
d
ent
s
w
ho
were t
e
st
e
d
,
of
71
res
p
o
n
d
ent
s
m
a
l
e
gende
r
t
h
ere a
r
e
5
6
ch
ild
r
e
n
(
4
0
.
3%)
w
e
r
e
l
o
w
visio
n
an
d no
r
m
al 1
5
ch
ildr
e
n (1
0.8%)
.
W
h
er
eas of
th
e
68
r
e
sp
ond
en
ts ar
e
f
e
male
sex 4
1
c
h
i
l
d
re
n (2
9.
5%
) wer
e
l
o
w vi
si
o
n
and
27 n
o
r
m
a
l
chi
l
d
re
n (
1
9
.
4
%
). St
at
i
s
t
i
cal anal
y
s
i
s
usi
ng chi
-
squ
a
re t
e
st
si
g
<
0.
05
(si
g
=0
.0
28
), m
eani
n
g t
h
at
t
h
e
r
e
is si
gn
ifican
t
relation
s
h
i
p
b
e
tween th
e sex
e
s
with
low
v
i
sion
.
In
b
i
variate an
alysis ob
tain
ed RR=1
.
3
0
8
can
b
e
sai
d
th
at t
h
e respo
n
d
e
n
t
s in
ch
ild
sex
m
e
n
will h
a
v
e
l
o
w
vi
si
on a
s
t
h
e ri
s
k
1
.
3
0
8
t
i
m
e
s gr
eater than the respondent
s in chil
dre
n
fem
a
le gender.From
research by
othe
rs said tha
t
there were n
o
signi
ficant d
i
ffere
nces
b
e
t
w
een
th
e sex
e
s in
th
is stu
d
y
(sig
=0.526
) [1
0
]
.
In
cont
rast
, t
h
e
di
ffe
rence i
n
pre
v
al
ence
bet
w
e
e
n b
o
y
s
a
n
d
gi
rl
s, w
h
e
r
e m
a
le were
6
6
c
h
i
l
d
re
n (
4
0.
4
9
%
)
an
d
fem
a
le were 97
ch
ild
ren
(59.51
%) [1
1
]
.
Th
is m
a
y b
e
related
to
n
o
t
ach
i
ev
ing
equ
a
lity o
f
h
ealth
serv
ices
bet
w
ee
n
gen
d
e
rs. Pa
re
nt
s t
e
nd t
o
pay
m
o
re at
t
e
nt
i
on t
o
boy
s t
h
an
gi
rl
s. Di
f
f
e
r
ences
i
n
t
h
e
fre
q
u
e
n
cy
o
f
di
sease m
o
rbi
d
i
t
y
bet
w
een
m
e
n an
d wom
e
n are part
l
y
due t
o
di
ffe
ren
ces i
n
w
o
r
k
, l
i
f
e ha
bi
t
s
, and
genet
i
cs or
co
nd
itio
ns fisi
o
l
og
is [12
]
.
4.
2.
Rela
tions
h
ip
Use
vision
Aid
w
i
th Low
Vis
i
on
Fr
o
m
th
e
r
e
sear
ch on
13
9 r
e
sp
ond
en
ts who
w
e
r
e
tested
, of th
e
48
r
e
spond
en
ts who
d
o
no
t use
v
i
su
al
aids there a
r
e
47 childre
n (33.8%)
were l
o
w
vision
and
normal 1
ch
ild
(0
.7
%).
Wh
ile th
e 9
1
resp
ond
en
t
s
who
use
vi
si
on ai
ds
are 5
7
c
h
i
l
d
re
n (
4
1.
0%)
wer
e
l
o
w
vi
si
o
n
a
nd
3
4
n
o
r
m
a
l
chi
l
d
re
n
(2
4.
5
%
). St
at
i
s
t
i
cal
anal
y
s
i
s
u
s
ing
ch
i-squ
a
re test with
si
g
<
0.05
(si
g
=0.0
05), m
ean
in
g that there is a
statistically signi
ficant assoc
i
ation
bet
w
ee
n t
h
e
us
e of
vi
si
o
n
ai
d
s
wi
t
h
l
o
w
vi
si
on i
n
ci
de
nt
.
In
bi
va
ri
at
e anal
y
s
i
s
obt
ai
ne
d
R
R
=
0.6
4
0
ca
n
be sai
d
th
at th
e respo
n
d
e
n
t
s in
ch
ildren
wh
o
do
no
t
u
s
e th
e to
o
l
s will h
a
v
e
as
mu
ch
risk
of d
e
v
e
lop
i
ng
lo
w
v
i
sion
0.
64
0 t
i
m
es gr
eat
er t
h
a
n
t
h
e
r
e
sp
on
de
nt
s i
n
chi
l
d
re
n t
a
ki
n
g
vi
s
u
al
ai
ds.
In
gene
ral
,
l
o
w vi
si
o
n
ai
d
s
exi
s
t
i
n
t
h
e
fo
rm
of sha
p
ed gl
asses
,
m
a
gni
fy
i
ng
gl
as
s, t
e
l
e
scope
(bi
noc
ul
ars
)
a
n
d C
C
T
V
.
C
h
i
l
dre
n
wi
t
h
l
o
w
vi
si
o
n
m
a
y
be hel
p
e
d
by
a v
a
ri
et
y
of l
o
w
vi
si
o
n
ai
ds a
n
d nee
d
encouragem
ent to us
e it either at hom
e,
at
scho
ol
or
o
n
t
h
e
pl
ay
gr
o
u
n
d
. C
h
i
l
d
re
n
oft
e
n r
e
fuse
ai
ds l
o
w
vi
si
o
n
o
n
first in
sp
ectio
n
,
b
u
t
with
en
courag
em
en
t an
d
trai
n
i
ng
in
the use of optical aids and
non optics they are abl
e
to
use it as
m
u
ch as
pos
sible. T
h
e
r
e
nee
d
s t
o
be
c
o
llaboration
between c
h
ildren, t
eachers
a
n
d parents
.
Because
forcing a c
h
ild to
wa
nt to
us
e
the t
o
ol can ca
use c
h
ildre
n t
o
rebe
l and re
fuse to
use t
h
em
and
do
not
want to a
k
nowledge the be
nefits of
the t
ool.
Until recently the use of lo
w
vision a
i
ds is still very low,
especi
al
l
y
fo
r
chi
l
d
re
n
beca
u
s
e m
a
ny
of t
h
ose
w
h
o
al
rea
d
y
ha
ve
a
fi
xe
d
vi
sual
ai
ds
d
o
not
wa
nt
t
o
use t
h
e
excu
se em
barrassed,
unc
om
fort
a
b
l
e
, hea
v
y
,
headac
he,
ha
ssle and lazy. The use
of
optical aids and non-
o
p
tical is
go
od and
righ
t
will in
crease th
e
po
wer
o
f
th
ei
r
v
i
sion
, t
h
e less th
ey
d
o
n
o
t
u
s
e t
h
e t
o
o
l
s of low
v
i
sion
aid
s
th
e
p
o
s
sib
ility o
f
eyesig
h
t
th
ey
wi
ll d
ecrease [1
3].
4.
3.
Relatio
n
ship Perio
d
ic
E
y
e Ex
a
m
inatio
n with
Lo
w Visio
n
From
t
h
e rese
arch
on
1
39
re
spo
n
d
e
n
t
s
w
h
o
were t
e
st
ed
, o
f
t
h
e 1
0
3
res
p
on
de
nt
s w
ho a
r
e n
o
t
ey
es
exam
i
n
ed reg
u
l
arl
y
are 76 c
h
i
l
d
ren
(5
4.
7%
)
were l
o
w
vi
si
on a
n
d n
o
rm
al
27 c
h
i
l
d
ren
(1
9.
4%)
.
Whi
l
e
t
h
e 3
6
responde
nts ey
es exam
ined regula
r
ly there
are 28 c
h
i
l
d
re
n (
2
0.
1%)
we
r
e
l
o
w
vi
si
o
n
a
n
d
8
n
o
rm
al
chi
l
d
re
n
(5.8
%). Statistical an
alysis u
s
in
g
ch
i-sq
u
a
re test w
ith
sig
> 0
.
05
(sig
=0
.6
84),
m
eaning t
h
at there
was no
statistical
ly sig
n
ifican
t asso
ci
atio
n
b
e
t
w
een
regu
lar ey
e e
x
am
i
n
at
i
ons wi
t
h
t
h
e i
n
ci
de
nc
e of l
o
w
vi
si
o
n
.
In
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Risk Fact
ors
of
Low
Vision
in Ch
ild
ren
(Tiu
r Dian
a
w
a
ti)
11
7
bi
va
ri
at
e anal
y
s
i
s
obt
ai
ne
d R
R
=
1.
05
4 can
be sai
d
t
h
at
th
e respo
n
d
e
n
t
s in
ch
ild
ren
with
ou
t eyes ex
amin
ed
regu
larly will
h
a
v
e
low
v
i
sion
as th
e
risk 1.0
5
4
tim
es
g
r
eater th
an
th
e resp
ond
en
ts in
child
ren eyes ex
amin
ed
reg
u
l
a
rl
y
,
t
h
e
r
e
i
s
a rel
a
t
i
onshi
p bet
w
een t
h
e bi
ol
o
g
i
cal abunda
nce,
pe
riodic eye
checkup the incide
nce
of low
vi
si
o
n
.
Th
e p
r
op
or
tion
o
f
low
v
i
sion
an
d
b
lindn
ess ar
e
th
e
pop
u
l
at
io
n
gr
oup
th
at d
o
e
s
no
t w
o
rk
f
o
llow
e
d
b
y
a gr
o
u
p
o
f
fa
r
m
ers or
, fi
s
h
er
m
e
n or
l
a
b
o
re
r
.
The
p
r
o
p
o
rt
i
o
n
of l
o
w
vi
si
o
n
an
d bl
i
n
d
n
ess
t
e
nds t
o
be hi
g
h
er i
n
ru
ral
areas t
h
a
n
u
r
b
a
n
,
b
u
t
al
m
o
st
evenl
y
di
st
ri
but
e
d
acr
os
s al
l
l
e
vel
s
of
ho
use
h
ol
d e
x
p
e
ndi
t
u
re
per
k
a
p
i
t
a
[8]
.
Lo
cation
with
lo
w v
i
sion can spread
to rem
o
te areas,
an
d
mo
s
t
l
y
f
r
o
m p
o
o
r
f
a
mi
l
i
e
s
s
o
a
s
t
o
p
e
r
f
o
r
m e
y
e
exam
inations a year once a
m
i
nim
u
m
is
a diffic
u
lt th
in
g
fo
r
t
h
em
t
o
do
.
I
t
tak
e
s k
now
ledg
e, ef
fo
r
t
,
in
v
e
stm
e
n
t
o
f
t
i
m
e
, en
erg
y
and
ev
en co
sts.
Kebu
lan ey
e co
nd
itio
n of th
e m
o
n
t
h
,
year t
o
year
will experien
ce
th
e d
i
fferen
c
e.
Alth
oug
h so
meti
m
e
s th
e d
i
fferen
c
e is
n
o
t
m
u
ch, it is still very im
p
o
r
tan
t
t
o
regu
larly ch
eck
t
h
e
eyes, so that the eyes are always h
eal
t
h
y
.
Thus
, i
f
t
h
er
e i
s
a vi
sual
o
r
ga
n
dy
sf
unct
i
o
n t
h
at
m
a
y not
or
not
w
e
are a
w
are, the
eye doct
o
r can
detect it early
,
and
i
f
necessa
r
y
, t
a
ke act
i
o
n
m
e
di
s [1
4]
.
4.
4.
The relati
o
ns
hip with L
o
w
Vision
Catar
a
ct
From
t
h
e rese
arch
o
n
1
3
9
r
e
sp
on
de
nt
s w
h
o we
re t
e
st
ed,
of t
h
e 4
5
re
s
p
o
n
d
ent
s
wi
t
h
a hi
st
ory
of
cataract
there
are 43
childre
n (30.9%
)
wer
e
l
o
w
vi
si
on
a
n
d
n
o
r
m
a
l
2 chi
l
d
re
n
(1
.4
%)
.
Whe
r
eas
of
t
h
e
94
resp
o
nde
nt
s w
ho
di
d n
o
t
hav
e
hi
st
ori
e
s o
f
cat
aract
are 61
chi
l
d
re
n (
4
3
.
9
%
) were l
o
w v
i
si
on an
d 3
3
n
o
rm
al
ch
ild
ren
(2
3.7%). Statistical
an
alysis u
s
in
g
ch
i-sq
u
a
re te
st with
sig
<
0.05
(sig
=0
.0
00), mean
ing
th
at th
ere is a
statistical
ly sig
n
i
fican
t asso
ci
atio
n
b
e
twee
n
a history
of i
n
cidence
of cat
ar
act with low vision. In
bivariate
an
alysis ob
tain
ed RR=1
.
47
2 can
b
e
said th
at th
e
r
e
spond
en
ts i
n
ch
ild
ren
who
h
a
v
e
a r
i
sk
of
d
e
v
e
lo
p
i
ng
cataract will h
a
v
e
low v
i
si
o
n
as m
u
ch
as 1
.
4
7
2
tim
es g
r
eater th
an
t
h
e resp
ond
en
ts in
ch
ild
ren
who
do
no
t
have
cataract.
Som
e
st
udi
es
of
l
o
w
vi
si
on
and
bl
i
n
d
n
ess i
ndi
cat
e
t
h
at ca
taract is the m
o
st c
o
mm
on cause is
found
in
th
e co
mm
u
n
ity an
d
in
creased
with
ag
e.
In th
e stud
y
c
o
n
d
u
ct
ed ot
he
rs
sa
i
d
t
h
at
10
8 pat
i
e
nt
s
we
re di
ag
no
s
e
d
pediatric cataract, only 46
patients with
58 eyes that meet the criteria
i
nkl
usi
[1
5]
. Thi
s
cau
sed
a
l
o
t
of
pat
i
e
nt
s w
ho
h
a
ve bee
n
di
ag
nos
ed a
r
e n
o
t
ret
u
r
n
e
d
t
o
t
h
e
cl
i
n
i
c
for
fu
rt
her m
a
nagem
e
nt
i
s
do
ne
bec
a
use
o
f
lack
o
f
fu
nd
s an
d lack of
kn
ow
ledg
e
p
a
r
e
n
t
s abou
t th
e state of
the ch
ild
's v
i
sion
so
do
n
o
t kn
ow
t
h
e l
o
ng
-
t
er
m
effects ca
used
by cataract. T
h
e m
a
in cause of loss of
vision
due to cata
r
act in ch
i
l
d
re
n i
s
am
bl
y
opi
a (l
azy
eye).
From
several
o
b
ser
v
at
i
o
ns an
d su
rvey
s i
n
c
o
m
m
uni
t
y
acquired cataract prevalence is higher in lowe
r
educat
e
d
g
r
o
u
p
s. Al
t
h
o
u
g
h
n
o
t
fo
un
d a di
r
ect
rel
a
t
i
onshi
p bet
w
ee
n l
e
v
e
l
of educat
i
o
n an
d t
h
e i
n
ci
dence
of
cataract, but the level of educ
ation can
af
fec
t
t
h
e soci
o-ec
o
nom
i
c
st
at
us, incl
u
d
i
n
g em
ploy
m
e
nt
and st
at
us o
f
nut
ri
t
i
on [1
5]
.
4.
5.
Rel
a
ti
ons
h
i
p
w
i
th
L
o
w
Vi
si
on Ref
r
ac
ti
ve Di
sord
ers
From
t
h
e rese
arch
o
n
1
3
9
r
e
sp
on
de
nt
s w
h
o we
re t
e
st
ed,
of t
h
e 8
3
re
s
p
o
n
d
ent
s
wi
t
h
a hi
st
ory
of
i
n
ci
denc
e o
f
i
n
ci
dence
of
ref
r
act
i
v
e di
so
rde
r
t
h
ere we
re 5
0
chi
l
d
re
n (
3
6.
0
%
) we
re l
o
w v
i
si
on an
d
no
r
m
al
33
ch
ild
r
e
n
(23
.
7%)
.
W
h
er
eas
of
th
e 56
r
e
spond
en
ts
w
h
o
d
i
d
n
o
t
h
a
v
e
a
h
i
st
o
r
y of
r
e
f
r
a
ctive d
i
sor
d
er
s th
er
e ar
e
54
chi
l
dre
n
(3
8.
8%)
we
re l
o
w
vi
si
o
n
a
n
d
2
n
o
rm
al
ch
ildren
(1.4%
)
. Sta
tistical analysis bi
variate
usi
n
g chi
-
sq
uar
e
test w
ith
sig
<
0.05
(
s
i
g
=0.000
),
m
ean
ing
th
at
th
ere is a s
t
atist
i
cal
ly sig
n
i
ficant association
between a
hi
st
ory
of
i
n
ci
dence
o
f
i
n
ci
d
e
nce
of
ref
r
act
i
v
e di
s
o
r
d
er
wi
t
h
t
h
e i
n
ci
de
nc
e of
l
o
w vi
si
on
. I
n
bi
vari
at
e a
n
al
y
s
i
s
obt
ai
ne
d
R
R
=
0
.
6
2
5
ca
n
be sai
d
t
h
at
t
h
e
res
p
on
de
nt
s i
n
chi
l
dre
n
w
h
o
ha
ve
i
n
ci
de
nce
o
f
i
n
ci
de
nce
of
re
f
r
act
i
v
e
d
i
sord
erwill h
a
v
e
th
e risk
o
f
lo
w v
i
si
o
n
as m
u
ch as
0
.
62
5 times g
r
eater than
th
e respon
den
t
s in ch
ildren
who
do
not
ha
ve i
n
ci
de
nce o
f
re
fract
i
v
e di
s
o
r
d
er. St
at
i
s
t
i
cal
an
alysis
m
u
lti
v
a
riate with
lo
g
i
stic regretio
n
with
sig=0.000, m
eaning that
re
fra
ctive dis
o
rder is fact
or m
o
st in
fl
u
e
n
tial to
o
c
cu
rren
t
of low
v
i
sion
.
I
n
stud
ies cond
u
c
ted
b
y
o
t
her
s
th
at
of
185
ch
ild
ren
,
fo
un
d 5 ch
ildren
with
in
ci
d
e
n
ce o
f
refractiv
e
di
so
rde
r
(
4
0%
m
a
l
e
and 6
0
%
fem
a
l
e
) were si
gni
fi
ca
nt
an
d
no
di
f
f
ere
n
t
wi
t
h
t
h
i
s
st
u
d
y
[
1
0]
. C
o
nt
rast
,
of
16
3
p
a
tien
t
s with
refractiv
e
d
i
sord
eri
n
ch
ildren
,
typ
e
s re
fractive dis
o
rde
r
s are the m
o
st common is
m
y
opia we
re
11
7
pat
i
e
nt
s
(7
1.
78
%).
1
1
R
e
fract
i
v
e
di
s
o
r
d
ers i
s
a
n
ey
e
di
sease that ca
n
be c
o
rrected with the
glasses, but it
seem
s
th
ere are still
m
a
n
y
p
e
o
p
l
e who
do
n
o
t
g
e
t
o
p
tim
a
l
co
rrection
.
Un
corrected
in
ci
d
e
n
ce o
f
refractiv
e
d
i
sord
erth
at can
lead
t
o
am
b
l
yo
p
i
a or lazy eye so
th
at
v
i
sio
n
will ten
d
t
o
d
eclin
e an
d
can
lead
t
o
b
lind
n
e
ss.
Th
is can
b
e
cau
s
ed
b
y
v
a
rious factors, su
ch
as th
e acti
v
ities and
h
a
b
its of
ch
ild
ren
,
su
ch
as h
a
b
its
d
o
not wan
t
to
u
s
e ai
d
s
su
ch
as
g
l
asses in
th
e ch
ild
's activ
ities o
u
t
si
d
e
th
e ho
m
e
o
r
in
t
h
e ho
m
e
, read
i
n
g
wh
ile lyin
g
d
o
wn
,
t
e
l
e
vi
si
on
vi
ew
i
ng
habi
t
s
are t
oo cl
ose an
d l
a
ck o
f
pa
re
nt
al
kn
o
w
l
e
d
g
e ab
o
u
t
t
h
e i
m
port
a
n
ce of
vi
sual
ai
d
s
fo
r
ch
ild
r
e
n
t
h
at do
n
o
t
kn
ow
t
h
e lo
ng-
ter
m
e
ffe
cts cause
d
by disord
er re
fracti
v
e
[10].
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I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
11
3 – 1
1
8
11
8
5.
CO
NCL
USI
O
NS
There
wa
s
no
r
e
l
a
t
i
onshi
p
bet
w
een
pe
ri
o
d
i
c
ey
e check
-
u
p
wi
t
h
t
h
e
i
n
ci
de
nce
of
l
o
w
vi
si
on
an
d t
h
ere
was a rel
a
t
i
ons
hi
p bet
w
een se
x, use
of vi
s
u
al
ai
ds, cat
ar
act and inci
dence
of re
fractive e
r
rorwith the inc
i
dence
of l
o
w vi
si
o
n
.
To dec
r
ease
d
t
h
e l
o
w
vi
si
on
t
h
ere sh
o
u
l
d
be an aware
n
es
s of health
beh
a
vi
o
u
rs i
n
t
h
e
use o
f
vision aids
as
needed and
ba
lan
ced
d
i
et with
su
fficien
t
p
h
y
sical
activ
ity
an
d
regu
lar.
ACKNOWLE
DGE
M
ENTS
The a
u
t
h
or
s a
r
e ve
ry
grat
ef
ul
t
o
L
o
w
Vi
s
i
on
Ser
v
i
ce C
e
nt
re P
e
rt
u
n
i
Yo
gy
aka
r
t
a
I
n
do
nesi
a a
n
d
Facu
lty of Public Health
Ahmad
Dah
l
an
Un
iv
ersity.
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