Main Article Content
Abstract
Background: Uncorrected refractive error was the primary cause of visual impairments in children and can leading to delays in academic development. Objective: This study aimed to investigate the association between uncorrected refractive errors in children and their academic performance. Methods: Ninety-one students from three classes selected randomly at a public junior high school in Padang, Indonesia, were included in this study. All students were interviewed and then underwent visual acuity and refractive examination. Student’s academic performance was assessed based on student reports from the last two semesters. Results: Most students are emmetropic (56.0%); however, one-fourth (25.3%) have uncorrected refractive error. Most students with uncorrected refractive error (69.6%) have no history of wearing eyeglasses. The mean presenting visual acuity of students with the uncorrected refractive error was 0.22+0.13, significantly lower than emmetropic students and students with no significant/corrected refractive error (p<0.001). Students with an uncorrected refractive error have no significant difference in mean report marks (89.00+2.07) from students in the other two groups (p:0.379).Conclusion: Poor distance visual acuity did not correlate with poor academic performance. Concerning most students with uncorrected refractive error who did not have eyeglasses, the provision of spectacles is essential in providing reasonable distance visual acuity.
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References
- Holden BA. Uncorrected refractive error: the major and most easily avoidable cause of vision loss. Community Eye Health. 2007;20(63):37-9.
- GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):e144-e60.
- Pokharel GP, Negrel AD, Munoz SR, Ellwein LB. Refractive error study in children: results from Mechi Zone, Nepal. American Journal of Ophthalmology. 2000;129(4):436-44.
- Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: results from La Florida, Chile. American Journal of Ophthalmology. 2000;129(4):445-54.
- Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB. Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol. 2000;129(4):427- 35.
- Resnikoff S, Pascolini D, Mariotti SP, Pokharel GP. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ. 2008;86(1):63-70.
- Rahi JS, Solebo AL, Cumberland PM. Uncorrected refractive error and education. BMJ : British Medical Journal. 2014;349:g5991.
- Rajkonwar S. Study of adjustment level of aspiration self concept and academic achievement visually handicapped school children of Assam. 2014.
- Ma X, Zhou Z, Yi H, Pang X, Shi Y, Chen Q, et al. Effect of providing free glasses on children’s educational outcomes in China: cluster randomized controlled trial. BMJ : British Medical Journal. 2014;349:g5740.
- Du K, Wang H, Ma Y, Guan H, Rozelle S. Effect of Eyeglasses on Student Academic Performance: What Matters? Evidence from a Randomized Controlled Trial in China. Int J Environ Res Public Health. 2022;19(17).
- Akinremi S, Ademola-Popoola D, Olatunji F, Ogunmuyiwa S. Prevalence of Refractive Errors and the Impact of Its Correction on Academic Performance of Primary School Children in Nigeria. Nigerian Journal of Ophthalmology. 2021;29:94.
- Latif MZ, Hussain I, Afzal S, Naveed MA, Nizami R, Shakil M, et al. Impact of Refractive Errors on the Academic Performance of High School Children of Lahore. Frontiers in Public Health. 2022;10.
- Dirani M, Zhang X, Goh LK, Young TL, Lee P, Saw SM. The Role of Vision in Academic School Performance. Ophthalmic Epidemiology. 2010;17(1):18-24.
- Glewwe P, Park A, Zhao M, editors. The Impact of Eyeglasses on the Academic Performance of Primary School Students: Evidence from a Randomized Trial in Rural China. Proceedings of the 10th Joint Conference on Agriculture, Food, and the Environment; 2006; Duluth, Minnesota: Center for International Food and Agricultural Policy.
- Martinez-Perez C, Alvarez-Peregrina C, Brito R, Sánchez-Tena MÁ, Lisboa GdIOI. The Evolution and the Impact of Refractive Errors on Academic Performance: A Pilot Study of Portuguese School-Aged Children. Children. 2022;9(6):840.
- Halim A, Suganda R, Sirait SN, Memed FK, Syumarti, Rini M, et al. Prevalence and associated factors of uncorrected refractive errors among school children in suburban areas in Bandung, Indonesia. Cogent Medicine. 2020;7(1):1737354.
- Nikmah ST, Rifada RM, Santoso PTR. Refractive Errors in State Junior High School Students in Bandung. Althea Medical Journal. 2016;3(4):545-8.
- Hashemi H, Fotouhi A, Yekta A, Pakzad R, Ostadimoghaddam H, Khabazkhoob M. Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. Journal of Current Ophthalmology. 2018;30(1):3-22.
- Mahayana IT, Indrawati SG, Pawiroranu S. The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population. Int J Ophthalmol. 2017;10(11):1771-6.
- Bhutia KL, Bhutia SC, Gupta N, Shenga DO. Prevalence of refractive errors among the school-going children in East Sikkim. Indian Journal of Ophthalmology. 2021;69(8):2018- 20.
- Dirani M, Chan YH, Gazzard G, Hornbeak DM, Leo SW, Selvaraj P, et al. Prevalence of refractive error in Singaporean Chinese children: the strabismus, amblyopia, and refractive error in young Singaporean Children (STARS) study. Invest Ophthalmol Vis Sci. 2010;51(3):1348- 55.
- Hashim S, Tan H-K, Wan Hitam WH, Ibrahim M. Prevalence of Refractive Error in Malay Primary School Children in Suburban Area of Kota Bharu, Kelantan, Malaysia. Annals of
- the Academy of Medicine, Singapore. 2008;37:940-6.
- Goh PP, Abqariyah Y, Pokharel GP, Ellwein LB. Refractive error and visual impairment in school-age children in Gombak District, Malaysia. Ophthalmology. 2005;112(4):678-
- Paudel P, Ramson P, Naduvilath T, Wilson D, Phuong HT, Ho SM, et al. Prevalence of vision impairment and refractive error in school children in Ba Ria - Vung Tau province, Vietnam. Clin Exp Ophthalmol. 2014;42(3):217-26.
- Magakwe TSS, Hansraj R, Xulu-Kasaba ZNQ. The impact of uncorrected refractive error and visual impairment on the quality of life amongst school-going children in Sekhukhune district (Limpopo), South Africa. Afr Vision Eye Health. 2022;81(1):a620.
- Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muñoz SR, et al. Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci. 2002;43(3):615-22.
- Maduka-Okafor FC, Okoye O, Ezegwui I, Oguego NC, Okoye OI, Udeh N, et al. Refractive Error and Visual Impairment Among School Children: Result of a South-Eastern Nigerian Regional Survey. Clin Ophthalmol. 2021;15:2345-53.
- Sharma IP, Lepcha NT, Lhamo T, Ellwein LB, Pokharel GP, Das T, et al. Visual impairment and refractive error in school children in Bhutan: The findings from the Bhutan School Sight Survey (BSSS 2019). PLoS One. 2020;15(9):e0239117.
- Bourne RRA, Jonas JB, Bron AM, Cicinelli MV, Das A, Flaxman SR, et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections. Br J Ophthalmol. 2018;102(5):575-85.
- Naidoo K, Ravilla D. Delivering refractive error s ervices: primary eye care centres and outreach. Community Eye Health. 2007;20(63):42-4.
- He M, Huang W, Zheng Y, Huang L, Ellwein LB. Refractive Error and Visual Impairment in School Children in Rural Southern China. Ophthalmology. 2007;114(2):374-82.e1.
- Thompson S, Naidoo K, Gonzalez-Alvarez C, Harris G, Chinanayi F, Loughman J. Barriers to use of refractive services in Mozambique. Optom Vis Sci. 2015;92(1):59-69.
- Dabideen R, Minto H, Naidoo K. Sourcing acceptable spectacles. Community Eye Health. 2007;20(63):47.
- Dhirar N, Dudeja S, Duggal M, Gupta PC, Jaiswal N, Singh M, et al. Compliance to spectacle use in children with refractive errors- a
- systematic review and meta-analysis. BMC Ophthalmology. 2020;20(1):71.
- Yasmin S, Minto H. Community perceptions of refractive errors in Pakistan. Community Eye Health. 2007;20(63):52-3.
- Singh S. Defining And Measuring Academic Performance of Hei Students- A Critical Review. 2021:3091-105.
- Narad A, Abdullah B. Academic Performance of Senior Secondary School Students: Influence of Parental Encouragement and School Environment. Rupkatha Journal on Interdisciplinary Studies in Humanities. 2016;8:12.
- Rabia M, Mubarak N, Tallat H, Nasir W. A Study on Study Habits and Academic Performance of Students. International Journal of Asian Social Science. 2017;7:891-7.
- Ibironke JO, Friedman DS, Repka MX, Katz J, Giordano L, Hawse P, et al. Child development and refractive errors in preschool children. Optom Vis Sci. 2011;88(2):181-7.
- Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Visual demands in modern Australian primary school classrooms. Clin Exp Optom. 2016;99(3):233-40.
- Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom. 2020;103(3):278-89.
- Dudovitz RN, Sim MS, Elashoff D, Klarin J, Slusser W, Chung PJ. Receipt of Corrective Lenses and Academic Performance of Low-Income Students. Academic Pediatrics. 2020;20(7):910-6.
- Ritty JM, Solan HA, Cool SJ. Visual and sensory- motor functioning in the classroom: a preliminary report of ergonomic demands. Journal of the American Optometric Association. 1993;64 4:238-44.
- Castellanos E, Davey PG, Remick-Waltman K. Can refractive error impact the academic performance? Investigative Ophthalmology & Visual Science. 2019;60(9):5836-.
- Horbec D. The Link between Reading and Academic Success. English in Australia. 2012;47:58- 67.
- Balan S, Katenga JE, Simon A, editors. Reading Habits and Their Influence on Academic Achievement Among Students at Asia Pacific International University. International
- Scholars Conference; 2019; Bandung, Indonesia: Universitas Advent Indonesia.
- Bashir I, Mattoo NH. A Study-on-Study Habits and Academic Performance among Adolescents (14-19) Years. International Journal of Social Science Tomorrow. 2012;1:1-5.
- Annamalai S, Muniandy B. Reading Habit and Attitude among Malaysian Polytechnic Students. International Online Journal of Educational Sciences. 2013;2013:32-41.
- Ameyaw S, Anto S. Read or Perish: Reading habit among students and its effect on academic performance: A case study of Eastbank Senior High School- Accra. Library Philosophy and Practice. 2018;2018.
- Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, near work, school achievement, and children's refractive error. Invest Ophthalmol Vis Sci. 2002;43(12):3633- 40.
- Williams S, Sanderson G, Share D, Silva P. Refractive error, IQ and reading ability: A longitudinal study from age seven to II. Developmental Medicine and Child Neurology - DEVELOP MED CHILD NEUROL. 2008;30:735-42.
- Guo Y, Liu LJ, Xu L, Lv YY, Tang P, Feng Y, et al. Outdoor Activity and Myopia among Primary Students in Rural and Urban Regions of Beijing. Ophthalmology. 2013;120(2):277-83.
- Dutheil F, Oueslati T, Delamarre L, Castanon J, Maurin C, Chiambaretta F, et al. Myopia and Near Work: A Systematic Review and Meta- Analysis. Int J Environ Res Public Health. 2023;20(1).
- Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci. 2007;48(8):3524-32.
- Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta- Analysis. PLoS One. 2015;10(10):e0140419.
- Permana GAR, Sari KAK, Aryani P. Hubungan perilaku penggunaan gadget terhadap miopia pada anak sekolah dasar kelas 6 di Kota Denpasar. Intisari Sains Medis. 2020;11(2):763–8.
- Budi A, Ginting CN, Chiuman L, Girsang E. The Association between Gadget Addiction and Myopia in the Medical Student of Universitas Prima Indonesia. International Journal of Scientific and Research Publications (IJSRP). 2022;12(1).
References
Holden BA. Uncorrected refractive error: the major and most easily avoidable cause of vision loss. Community Eye Health. 2007;20(63):37-9.
GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):e144-e60.
Pokharel GP, Negrel AD, Munoz SR, Ellwein LB. Refractive error study in children: results from Mechi Zone, Nepal. American Journal of Ophthalmology. 2000;129(4):436-44.
Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: results from La Florida, Chile. American Journal of Ophthalmology. 2000;129(4):445-54.
Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB. Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol. 2000;129(4):427- 35.
Resnikoff S, Pascolini D, Mariotti SP, Pokharel GP. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ. 2008;86(1):63-70.
Rahi JS, Solebo AL, Cumberland PM. Uncorrected refractive error and education. BMJ : British Medical Journal. 2014;349:g5991.
Rajkonwar S. Study of adjustment level of aspiration self concept and academic achievement visually handicapped school children of Assam. 2014.
Ma X, Zhou Z, Yi H, Pang X, Shi Y, Chen Q, et al. Effect of providing free glasses on children’s educational outcomes in China: cluster randomized controlled trial. BMJ : British Medical Journal. 2014;349:g5740.
Du K, Wang H, Ma Y, Guan H, Rozelle S. Effect of Eyeglasses on Student Academic Performance: What Matters? Evidence from a Randomized Controlled Trial in China. Int J Environ Res Public Health. 2022;19(17).
Akinremi S, Ademola-Popoola D, Olatunji F, Ogunmuyiwa S. Prevalence of Refractive Errors and the Impact of Its Correction on Academic Performance of Primary School Children in Nigeria. Nigerian Journal of Ophthalmology. 2021;29:94.
Latif MZ, Hussain I, Afzal S, Naveed MA, Nizami R, Shakil M, et al. Impact of Refractive Errors on the Academic Performance of High School Children of Lahore. Frontiers in Public Health. 2022;10.
Dirani M, Zhang X, Goh LK, Young TL, Lee P, Saw SM. The Role of Vision in Academic School Performance. Ophthalmic Epidemiology. 2010;17(1):18-24.
Glewwe P, Park A, Zhao M, editors. The Impact of Eyeglasses on the Academic Performance of Primary School Students: Evidence from a Randomized Trial in Rural China. Proceedings of the 10th Joint Conference on Agriculture, Food, and the Environment; 2006; Duluth, Minnesota: Center for International Food and Agricultural Policy.
Martinez-Perez C, Alvarez-Peregrina C, Brito R, Sánchez-Tena MÁ, Lisboa GdIOI. The Evolution and the Impact of Refractive Errors on Academic Performance: A Pilot Study of Portuguese School-Aged Children. Children. 2022;9(6):840.
Halim A, Suganda R, Sirait SN, Memed FK, Syumarti, Rini M, et al. Prevalence and associated factors of uncorrected refractive errors among school children in suburban areas in Bandung, Indonesia. Cogent Medicine. 2020;7(1):1737354.
Nikmah ST, Rifada RM, Santoso PTR. Refractive Errors in State Junior High School Students in Bandung. Althea Medical Journal. 2016;3(4):545-8.
Hashemi H, Fotouhi A, Yekta A, Pakzad R, Ostadimoghaddam H, Khabazkhoob M. Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. Journal of Current Ophthalmology. 2018;30(1):3-22.
Mahayana IT, Indrawati SG, Pawiroranu S. The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population. Int J Ophthalmol. 2017;10(11):1771-6.
Bhutia KL, Bhutia SC, Gupta N, Shenga DO. Prevalence of refractive errors among the school-going children in East Sikkim. Indian Journal of Ophthalmology. 2021;69(8):2018- 20.
Dirani M, Chan YH, Gazzard G, Hornbeak DM, Leo SW, Selvaraj P, et al. Prevalence of refractive error in Singaporean Chinese children: the strabismus, amblyopia, and refractive error in young Singaporean Children (STARS) study. Invest Ophthalmol Vis Sci. 2010;51(3):1348- 55.
Hashim S, Tan H-K, Wan Hitam WH, Ibrahim M. Prevalence of Refractive Error in Malay Primary School Children in Suburban Area of Kota Bharu, Kelantan, Malaysia. Annals of
the Academy of Medicine, Singapore. 2008;37:940-6.
Goh PP, Abqariyah Y, Pokharel GP, Ellwein LB. Refractive error and visual impairment in school-age children in Gombak District, Malaysia. Ophthalmology. 2005;112(4):678-
Paudel P, Ramson P, Naduvilath T, Wilson D, Phuong HT, Ho SM, et al. Prevalence of vision impairment and refractive error in school children in Ba Ria - Vung Tau province, Vietnam. Clin Exp Ophthalmol. 2014;42(3):217-26.
Magakwe TSS, Hansraj R, Xulu-Kasaba ZNQ. The impact of uncorrected refractive error and visual impairment on the quality of life amongst school-going children in Sekhukhune district (Limpopo), South Africa. Afr Vision Eye Health. 2022;81(1):a620.
Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muñoz SR, et al. Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci. 2002;43(3):615-22.
Maduka-Okafor FC, Okoye O, Ezegwui I, Oguego NC, Okoye OI, Udeh N, et al. Refractive Error and Visual Impairment Among School Children: Result of a South-Eastern Nigerian Regional Survey. Clin Ophthalmol. 2021;15:2345-53.
Sharma IP, Lepcha NT, Lhamo T, Ellwein LB, Pokharel GP, Das T, et al. Visual impairment and refractive error in school children in Bhutan: The findings from the Bhutan School Sight Survey (BSSS 2019). PLoS One. 2020;15(9):e0239117.
Bourne RRA, Jonas JB, Bron AM, Cicinelli MV, Das A, Flaxman SR, et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections. Br J Ophthalmol. 2018;102(5):575-85.
Naidoo K, Ravilla D. Delivering refractive error s ervices: primary eye care centres and outreach. Community Eye Health. 2007;20(63):42-4.
He M, Huang W, Zheng Y, Huang L, Ellwein LB. Refractive Error and Visual Impairment in School Children in Rural Southern China. Ophthalmology. 2007;114(2):374-82.e1.
Thompson S, Naidoo K, Gonzalez-Alvarez C, Harris G, Chinanayi F, Loughman J. Barriers to use of refractive services in Mozambique. Optom Vis Sci. 2015;92(1):59-69.
Dabideen R, Minto H, Naidoo K. Sourcing acceptable spectacles. Community Eye Health. 2007;20(63):47.
Dhirar N, Dudeja S, Duggal M, Gupta PC, Jaiswal N, Singh M, et al. Compliance to spectacle use in children with refractive errors- a
systematic review and meta-analysis. BMC Ophthalmology. 2020;20(1):71.
Yasmin S, Minto H. Community perceptions of refractive errors in Pakistan. Community Eye Health. 2007;20(63):52-3.
Singh S. Defining And Measuring Academic Performance of Hei Students- A Critical Review. 2021:3091-105.
Narad A, Abdullah B. Academic Performance of Senior Secondary School Students: Influence of Parental Encouragement and School Environment. Rupkatha Journal on Interdisciplinary Studies in Humanities. 2016;8:12.
Rabia M, Mubarak N, Tallat H, Nasir W. A Study on Study Habits and Academic Performance of Students. International Journal of Asian Social Science. 2017;7:891-7.
Ibironke JO, Friedman DS, Repka MX, Katz J, Giordano L, Hawse P, et al. Child development and refractive errors in preschool children. Optom Vis Sci. 2011;88(2):181-7.
Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Visual demands in modern Australian primary school classrooms. Clin Exp Optom. 2016;99(3):233-40.
Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom. 2020;103(3):278-89.
Dudovitz RN, Sim MS, Elashoff D, Klarin J, Slusser W, Chung PJ. Receipt of Corrective Lenses and Academic Performance of Low-Income Students. Academic Pediatrics. 2020;20(7):910-6.
Ritty JM, Solan HA, Cool SJ. Visual and sensory- motor functioning in the classroom: a preliminary report of ergonomic demands. Journal of the American Optometric Association. 1993;64 4:238-44.
Castellanos E, Davey PG, Remick-Waltman K. Can refractive error impact the academic performance? Investigative Ophthalmology & Visual Science. 2019;60(9):5836-.
Horbec D. The Link between Reading and Academic Success. English in Australia. 2012;47:58- 67.
Balan S, Katenga JE, Simon A, editors. Reading Habits and Their Influence on Academic Achievement Among Students at Asia Pacific International University. International
Scholars Conference; 2019; Bandung, Indonesia: Universitas Advent Indonesia.
Bashir I, Mattoo NH. A Study-on-Study Habits and Academic Performance among Adolescents (14-19) Years. International Journal of Social Science Tomorrow. 2012;1:1-5.
Annamalai S, Muniandy B. Reading Habit and Attitude among Malaysian Polytechnic Students. International Online Journal of Educational Sciences. 2013;2013:32-41.
Ameyaw S, Anto S. Read or Perish: Reading habit among students and its effect on academic performance: A case study of Eastbank Senior High School- Accra. Library Philosophy and Practice. 2018;2018.
Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, near work, school achievement, and children's refractive error. Invest Ophthalmol Vis Sci. 2002;43(12):3633- 40.
Williams S, Sanderson G, Share D, Silva P. Refractive error, IQ and reading ability: A longitudinal study from age seven to II. Developmental Medicine and Child Neurology - DEVELOP MED CHILD NEUROL. 2008;30:735-42.
Guo Y, Liu LJ, Xu L, Lv YY, Tang P, Feng Y, et al. Outdoor Activity and Myopia among Primary Students in Rural and Urban Regions of Beijing. Ophthalmology. 2013;120(2):277-83.
Dutheil F, Oueslati T, Delamarre L, Castanon J, Maurin C, Chiambaretta F, et al. Myopia and Near Work: A Systematic Review and Meta- Analysis. Int J Environ Res Public Health. 2023;20(1).
Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci. 2007;48(8):3524-32.
Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta- Analysis. PLoS One. 2015;10(10):e0140419.
Permana GAR, Sari KAK, Aryani P. Hubungan perilaku penggunaan gadget terhadap miopia pada anak sekolah dasar kelas 6 di Kota Denpasar. Intisari Sains Medis. 2020;11(2):763–8.
Budi A, Ginting CN, Chiuman L, Girsang E. The Association between Gadget Addiction and Myopia in the Medical Student of Universitas Prima Indonesia. International Journal of Scientific and Research Publications (IJSRP). 2022;12(1).