CORTICAL VISUAL IMPAIRMENT
Cortical Visual Impairment (CVI) is a brain-based visual impairment caused by damage to the visual pathways or visual processing areas of the brain.
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WHAT IS CORTICAL VISION IMPAIRMENT?
Cortical vision impairment (CVI) is a medical problem where there is a range of abnormal visual function which is due to a neurologic disorder affecting the visual part of the brain. A child with CVI has an eye exam that does not explain the level of dysfunction seen. It is one of the most frequent causes of visual impairment in children from developed countries.
HOW DOES NORMAL VISION WORK?
An individual experiences vision from the eye and brain working together. The awake person’s eye takes a picture, which travels to the brain. The brain senses the image and coordinates it with other stimuli. The brain creates a response to what has been seen
HOW VISION WORKS IN CVI
The eye structure in CVI is usually normal or almost normal. The eye takes a picture of the object and transmits the message to the brain. Abnormalities in the visual areas of the brain result in atypical characteristics and behaviors depending upon which part of the brain is involved.
What Causes CVI?
CVI is caused by abnormal function in the parts of the brain responsible for visual function. Associated medical problems include prematurity, stroke, decreased blood or oxygen to the brain, structural abnormalities, infection, increased pressure in the brain, seizure, metabolic disease, infection, head trauma, genetic and other neurologic disorders.
Symptoms: Visual Characteristics of CVI
Here is a partial list of characteristics* and a child’s level of function and other neurodevelopmental issues may influence characteristics.
• Strong preference for certain colors
• Extra time needed to react to visual tasks compared to typically sighted child
• Areas where child does not see as well
• Better response to familiar objects
• Abnormal response/need for light
• Atypical visual responses/actions
• Better vision when viewing moving visual stimuli
• More difficulty with seeing distant objects
• Negative effect of complexity on visual performance
* See Roman-Lantzy, C. in Academic Resources below.
Your child’s specific condition should be discussed with your pediatric ophthalmologist so they can conduct an accurate CVI assessment and diagnosis.
CVI TREATMENT
An early recognition, diagnosis, treatment, and intervention of cortical visual impairment may allow a child better and earlier access to learning.
The pediatric ophthalmologist can provide a diagnosis of visual impairment from CVI, provide the necessary eye treatment for the child (e.g., glasses, surgery), and request an evaluation for vision services. Services may be provided through a state program, school district, or early intervention program, depending upon the child’s age and state of residence.
A teacher of the visually impaired or other trained team member will provide an evaluation and recommendations for accommodations to aid in accessing learning materials.
Medical diseases associated with CVI should have appropriate treatment by the primary care physician, pediatric neurologist, or other appropriate pediatric specialist.
DO CHILDREN WITH CVI NEED AN EYE EXAMINATION?
Yes. Some children with CVI have eye problems that require a diagnosis and treatment by a pediatric ophthalmologist, such as glasses or eye muscle surgery.
The pediatric ophthalmologist also makes a diagnosis, providing the medical necessity for requesting an evaluation for vision services.
WHAT TYPE OF STIMULATION
IS HELPFUL FOR INFANTS WITH CVI?
IS HELPFUL FOR INFANTS WITH CVI?
• Using highly contrasted, lighted, reflective, and moving objects
• Extra cues such as vibration or sound
• Providing a simple environment for visual tasks
• Providing more time than what a child would normally need for a visual task completion
• Providing periods of rest if child is physically tired from visual tasks
HOW CAN PARENTS OR CAREGIVERS HELP THE PHYSICIANS CARE FOR CHILDREN WITH CVI?
Parents/caregivers should keep a written list of specific problems/changes/observations for discussion at each physician visit.
Contact Us
SHARON LEHMAN, MD
Attending Physician, Pediatric Ophthalmology
Wills Eye Hospital
Clinical Professor of Ophthalmology
Clinical Professor of Pediatrics
Sidney Kimmel Medical College at Thomas Jefferson University