As defined by the American Association for Pediatric Ophthalmology and Strabismus(AAPOS), Cortical Visual Impairment (CVI) is “a decreased visual response due to a neurological problem affecting the visual part of the brain. Typically, a child with CVI has a normal eye exam or has an eye condition that cannot account for the abnormal visual behavior. It is one of the most frequent causes of visual impairment in children from developed countries.”
What causes CVI?
As described by AAPOS: “CVI is caused by any process that damages the visual parts of the brain. Examples include: stroke, decreased blood supply, decreased oxygenation, brain malformation or infection, hydrocephalus (increased pressure in the brain), seizure, metabolic disease, head trauma and other neurologic disorders.”
What does CVI look like?
Dr. Christine Roman-Lantzy, who is a leading international expert in the assessment of, intervention and educational approach to CVI, has developed a one of its kind assessment tool to evaluate a child with CVI that guides the ongoing educational interventions to allow the child visual access to their environment and materials. She is Director of the Pediatric VIEW (Vision Information and Evaluation at West Penn Hospital) Program in Pittsburgh, private consultant for CVI Resources, and author of Cortical Visual Impairment: An Approach to Assessment and Intervention.
The following are characteristics of visual behavior unique to CVI that she has identified, described, and quantified with her assessment tool, the CVI Range:
- Color preference
- Difficulty with complexity
- Visual field preference
- Visual latency
- Difficulty with distance viewing
- Difficulty with visual novelty
- Light-gazing and Non-purposeful gaze
- Need for movement
- Difficulty with visually guided reach
- Atypical or absent visual reflexes
Some or all of these characteristics can interfere with a child with CVI’s visual functioning. There are varying degrees of each characteristic’s impact that can be determined through careful, and systematic evaluation of the child’s visual functioning using the CVI Range.
What can you do about CVI?
The good news is that visual functioning of children with CVI can improve, no matter if they have additional disabilities. And with additional disabilities present, it is very important that their visual needs are addressed so that they are provided with materials and adaptations to allow them to use the vision they have. With appropriate adaptations, accommodations, and intentional interventions, greater improvement should occur to allow them to grow in all areas of development. That is why getting an accurate baseline functional vision evaluation with the CVI Range is so important to provide a starting point of where your child’s vision is at and how to elicit use of their available vision. This, in turn, guides interventions and accommodations that will meet your child where their visual abilities are and continue to expand the use of their vision.
If you don’t have a provider that is well versed in CVI, seeking out someone who is to provide ongoing assessment and recommendations is key in helping your child make progress in their educational or therapeutic programs.