Cerebral Visual Impairment (CVI)

What is CVI?

Cerebral visual impairment, often referred to as cortical visual impairment or CVI, is a condition resulting from damage to the areas of the brain responsible for processing visual information. This disorder is most frequently observed in infants and young children, but it can persist into adulthood.

A child diagnosed with CVI experiences vision challenges that stem from their brain rather than any issues with their eyes. Typically, the eyes transmit electrical signals to the brain, which interprets these signals into the images we perceive. In individuals with CVI, the brain struggles to process and comprehend these visual signals effectively.

CVI stands as a primary contributor to vision loss in children across the United States. While some children with CVI may experience improvements in their vision over time, each case is unique. If your child is diagnosed with CVI, it is crucial to ensure they receive early intervention, therapeutic support, educational assistance, and other specialized services to aid in their development and learning.

What are the symptoms of CVI?

CVI can lead to a range of visual difficulties that vary in severity from mild to profound. Children with CVI may encounter challenges such as:

  • Reacting to visual stimuli

  • Perceiving specific aspects of their surroundings, particularly in dynamic or busy environments

  • Identifying faces and objects

  • Recognizing items in cluttered settings

  • Reaching for objects while visually tracking them

  • Comprehending what they observe

Parents may also observe that their child with CVI:

  • Responds slowly to visual signals

  • Shows a preference for moving objects

  • Tends to focus on specific areas of their visual field, such as their peripheral vision

Some children with CVI may fixate on light sources (like lamps or sunlight), while others may exhibit light sensitivity.

Additionally, children with CVI often have other disabilities or health issues, including:

  • Developmental disabilities

  • Cerebral palsy (a neurological disorder affecting movement)

  • Epilepsy (a neurological condition characterized by seizures)

  • Hearing impairments

What causes CVI?

CVI arises from an injury to the brain. These injuries typically occur before, during, or shortly after birth. Common factors contributing to CVI in infants and young children include:

  • Insufficient oxygen or blood flow to the brain, often due to a stroke

  • Hydrocephalus (accumulation of fluid in the brain)

  • Infections that affect the brain

  • Head trauma

  • Certain genetic disorders

Premature infants (those born early) are at a heightened risk of developing CVI.

Can adults get CVI?

Adults can also experience vision issues following a traumatic brain injury, such as a head injury or stroke that impacts the brain. Veterans may face an increased risk of visual impairments due to combat-related injuries.

These vision issues are sometimes referred to as acquired CVI, but they differ from CVI. Brain injuries sustained later in life typically present different symptoms compared to CVI, which is associated with early-life injuries.

If you or someone you care about is experiencing vision difficulties due to a brain injury, consult a healthcare professional about vision rehabilitation and other supportive services. Vision rehabilitation can assist individuals with brain injuries in maximizing their visual capabilities.

How will my child’s doctor check for CVI?

There is no singular test to diagnose CVI. If you suspect your child may have vision issues, the initial step is to obtain a thorough eye examination to determine if the problem lies within their eyes.

If the examination does not reveal any ocular issues that could account for your child's symptoms, it may indicate that the problem is neurological. To receive a diagnosis, your child will need to consult an eye specialist experienced in CVI. They may also need to see other professionals, such as a pediatric neurologist or a neuro-ophthalmologist.

The doctor will assess your child and inquire about their medical history. They may also recommend imaging studies of your child's brain.

Diagnosing CVI can be challenging, but obtaining the correct diagnosis is essential for ensuring your child receives the necessary support. If your child exhibits vision problems that cannot be attributed to eye issues or corrected with glasses, discuss with your doctor the possibility of CVI, especially if your child has experienced a brain injury.

What’s the treatment for CVI?

While there is no cure for CVI, vision rehabilitation can assist individuals with CVI in optimizing their visual abilities. For some individuals with CVI, vision issues may improve over time without intervention, although experts are uncertain about the reasons behind this phenomenon.

Early intervention, therapy, educational support, and other specialized services are vital for infants and children with CVI to facilitate their development and learning.

If your child has been diagnosed with CVI, it is important to collaborate with their healthcare providers to establish the most effective care plan. Some children may require treatment for additional health conditions they may have alongside CVI.