Visual function questions
| 1 | Do you have any difficulty reading? |
| 2 | Do you have any difficulty recognising faces? |
| 3 | Do you have any difficulty telling the difference between a K 10 and a K 20 note because of your eyesight? |
| 4 | Do you have any difficulty walking around at night because of your eyesight? |
| 5 | Do you have any difficulty recognising food on your plate? |
| 6 | Do you have any difficulty avoiding potholes, stones, or branches when you are walking because of your eyesight? |
| 7 | Do you have any difficulty cooking, chopping vegetables, or pouring water because of your eyesight? |
| 8 | Do you have any difficulty using the latrine without assistance because of your eye sight? |
| 9 | Do you have any difficulty participating in social activities like weddings or funerals because of your eyesight? |
| 10 | Do you have any difficulty sorting stones from rice or beans because of your eyesight? |
| 11 | Do you have any difficulty sewing or making baskets or mats because of your eyesight? |
| 12 | Do you have any difficulty tending your garden because of your eyesight? |
| 13 | Do you have any difficulty repairing your house because of your eyesight? |