Atypical Visual Pathways and CVI (Cortical Visual Impairment):
 The Importance of Early Detection and Management

July 10, 2024
Atypical Visual Pathways and CVI (Cortical Visual Impairment):
 The Importance of Early Detection and Management
Published on  Updated on  

Imagine a scenario where a parent or caregiver takes their child to the optometrist because it seems the child is not seeing clearly. After a comprehensive vision exam, the optometrist reports that the child’s ocular system is functioning normally. The parent leaves the office confused and frustrated, wondering why their child is still experiencing vision problems. Could Cortical Visual Impairment (CVI) be the underlying issue?

What is Cortical Visual Impairment?

Cortical Visual Impairment (CVI), also known as Cerebral Visual Impairment, is a leading cause of vision impairment in children in the United States, yet it is the least recognized. It is estimated that around 180,000 children in the U.S. have CVI, but this diagnosis is often misunderstood and underrepresented.

CVI is a neurological form of visual impairment caused by damage or atypical structures in the visual pathways and/or visual processing centers of the brain (Roman Lantzy, 2018). Unlike other visual impairments that stem from issues with the eyes themselves, CVI affects the brain’s ability to accurately interpret and understand what the eyes see. This condition can impact both typically developing children and those with mild to severe disabilities.

Causes of CVI

Several types of brain trauma can lead to CVI, including:

  • Hypoxic Ischemic Encephalopathy (HIE): This occurs in term-born infants when the brain does not receive enough oxygen.
  • Periventricular Leukomalacia (PVL): This is common in preterm infants and involves the death of small areas of brain tissue around the ventricles.
  • Traumatic Brain Injury (TBI): Any significant impact to the head can result in CVI.
  • Neonatal Hypoglycemia: Low blood sugar levels in newborns can cause brain damage.
  • Infections: Conditions such as viral meningitis can affect the brain's visual processing centers.
  • Severe Epilepsy: Repeated seizures can cause brain damage, impacting vision.
  • Metabolic Disorders: Conditions that affect the body’s metabolism can also impact brain function and vision.

Recognizing the Signs of CVI

Recognizing the signs of CVI early is crucial for effective management. Some of the common signs include:

  • Light-gazing: An unusual fascination with light sources.
  • Poor Visual Acuity: Blurred vision or difficulty seeing clearly.
  • Visual Field Loss: Missing parts of the visual field.
  • Dominating Peripheral Fields: Relying more on peripheral vision than central vision.
  • Visual and/or Auditory Noise: Difficulty processing visual and auditory information simultaneously.
  • Visual Fatigue: Eyes tire easily from visual tasks.
  • Latency or Atypical Visual Response: Delayed or unusual responses to visual stimuli.
  • Color Preference: A strong preference for certain colors.
  • Absence of Visual Guided Reach: Difficulty using vision to guide hand movements.

Importance of Early Detection

At Good-Lite, we emphasize that early detection is key to managing any visual impairment condition, including CVI. Identifying CVI early allows for the implementation of strategies and interventions that can significantly improve a child's quality of life.

Managing CVI

  • While there is no cure for CVI, various strategies can help address visual difficulties:
  • Seek Specialized Care: If CVI is suspected, consult a pediatric ophthalmologist familiar with CVI or a neuro-ophthalmologist.
  • Vision Rehabilitation (Vision Therapy): This can include exercises and activities designed to improve visual processing.
  • Educational Support: Inform the child’s early interventionist or teacher about the CVI diagnosis. Request a teacher of the visually impaired to target specific visual behaviors and provide tailored interventions.
  • Environmental Modifications: Adjust the child’s surroundings to reduce visual and auditory noise, use high-contrast materials, and ensure good lighting.

Conclusion

Understanding CVI and recognizing its signs early is vital for effective management. By partnering with organizations like Good-Lite, parents and caregivers can educate themselves about CVI and advocate for the necessary interventions and support. Early detection and proactive management can make a profound difference in the lives of children with CVI, helping them navigate their visual challenges and achieve their full potential.

For more information about Cortical Visual Impairment and available resources, visit Perkins School for the Blind's CVI Now.

At Good-Lite, we are committed to promoting early detection and providing resources to support children with visual impairments. Sight is precious, and we believe in the importance of protecting and enhancing it at every stage of life.

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