Cerebral Visual Impairment: Everything You Should Know

Defining Cerebral Visual Impairment

Cerebral Visual Impairment (commonly referred to as CVI) is a form of visual impairment caused by the brain not being able to process information that comes through the visual pathways from the eyes.

People who suffer from CVI struggle with visual attention and visual recognition. Some of them see the world as distorted and unrecognisable, while others can focus but might struggle to understand what they see. A crowded setting, a hot day, or fatigue has the potential to make vision extremely difficult. 

Cerebral Visual Impairment is the commonest cause of visual impairment in children in the developed world. It is the most common cause of registrable visual impairment in the UK, and according to The CVI Project, at least 3% of children in mainstream school—equating to one child in every classroom—had CVI-related visual difficulties

CVI is often associated with other neurologic deficits including cerebral palsy, developmental delay, microcephaly, hearing problems, epilepsy, and hypotonia.

Causes Of Cerebral Visual Impairment

CVI is caused by an injury to the brain. These injuries usually happen before, during, or shortly after birth, but they can also occur in adulthood. Common causes of CVI include:

1. Lack of oxygen or blood supply to the brain.
2. Hydrocephalus (build-up of fluid in the brain).
3. Infections that reach the brain (such as meningitis or encephalitis).
4. Head injury.
5. Certain genetic conditions.

Symptoms Of Cerebral Visual Impairment

CVI can cause a variety of visual problems that can range from mild to severe. Some common symptoms of this condition include:

1. Photophobia (being sensitive to light).
2. Poor social gaze (not being able to look into people’s eyes).
3. Never fixing on objects for long.
4. Trouble with smooth eye movements.
5. Poor visual acuity (not doing well on sight test charts).
6. Visual field loss.
7. Being clumsy with objects.
8. Getting quickly tired when doing tasks that need vision.
9. Trouble recognising familiar people or places.
10. Finding it harder to see when it’s noisy.

Long-Term Complications Of Cerebral Visual Impairment

Long-term effects of CVI can vary greatly depending on the severity of the condition and the individual. Some common effects may include:

1. Delayed Developmental Milestones: People with CVI may experience delays in motor skills, speech, and language development due to impaired visual input.
2. Learning Disabilities: Issues with reading, writing, and arithmetic, especially in visually demanding tasks, are common. This can lead to academic challenges and require special education interventions.
3. Social Interaction Difficulties: Problems with facial recognition and interpreting social cues can make social interactions challenging, potentially leading to social isolation or anxiety.
4. Behavioural Issues: Frustration, anxiety, or behavioural problems may arise due to the challenges in navigating the environment and communicating effectively.
5. Mental Health Concerns: Anxiety, depression, and low self-esteem are potential long-term issues due to ongoing struggles with visual processing and its impact on daily life.
6. Reduced Independence: Long-term independence may be affected, requiring ongoing assistance with daily tasks, particularly those that are visually demanding.
7. Reduced Quality of Life: The cumulative effect of visual, cognitive, social, and emotional challenges can significantly impact overall quality of life, necessitating comprehensive support from healthcare providers, educators, and families.

Diagnosis And Management

It’s important to diagnose cerebral visual impairment as early as possible to help sufferers get the support they need to develop as normally as possible. Improving brain imaging and tests for different visual problems will help speed up diagnosis and make it easier to recognise the symptoms.

CVI can be diagnosed by a medical provider. It’s important that that person has a strong understanding of CVI, as it can often be misdiagnosed or even dismissed.   

There is no treatment or cure for most types of cerebral visual impairment. However, several things may help people to see more clearly. Vision rehabilitation can help people with CVI make the most of their vision. For some people with CVI, vision problems get better over time. In most cases, people would need early intervention and therapy, educational support, and other special services to help them develop and learn.

Catering to people with CVI requires a combined and coordinated effort between the ophthalmologist, neurologist and rehabilitation services. The problems in patients with cerebral visual loss are not limited to vision, but are also cognitive and social.  A multidisciplinary approach is thus necessary not just for diagnosis but also for management.

Here are some of the ways through which CVI can be managed:

1. Vision Therapy: Customised vision therapy exercises can help improve visual processing skills. These may include activities to enhance eye movement control, visual attention, and the ability to process visual information.
2. Use of Low Vision Aids: Devices such as magnifiers, screen readers, and other assistive technologies can be used to enhance visual function and compensate for specific deficits.
3. Environmental Modifications: Simplifying and organising the environment can reduce visual clutter and enhance visual recognition. High-contrast colours, clear labelling, and good lighting can also improve visual accessibility.
4. Assistive Technology: Tools such as large print books, audio books, Braille, and computer-based learning aids can be critical in supporting academic progress.
5. Cognitive Rehabilitation: Techniques to improve attention, memory, and problem-solving skills can be helpful in managing cognitive deficits associated with CVI.
6. Behavioural Therapy: Addressing emotional and behavioural challenges through counselling or behavioural therapy can help reduce anxiety, improve social skills, and build self-esteem.

If you have concerns about CVI, it's recommended to consult with an eye care professional or a specialist in visual impairments. They can provide a comprehensive evaluation and recommend appropriate interventions.

Got any questions regarding eye care and treatment? Please don’t hesitate to get in touch with us. We are more than happy to discuss queries with you over the phone (0800 093 1110) or email (enquiry@optimax.co.uk).