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The infant who is visually unresponsive on a cortical basis
A H Weiss1, J P Kelly, J O Phillips
1Department of Ophthalmology, Children's Hospital & Regional Medical Center and University of Washington, Seattle, Washington 98105, USA.
Ophthalmology
|November 20, 2001
Summary
Visually unresponsive infants with normal eyes may have visual inattention (VI) or cortical visual impairment (CVI). Differentiating these conditions in infancy requires developmental assessment and specific visual and oculomotor tests.
Area of Science:
- Neuroscience
- Ophthalmology
- Developmental Pediatrics
Background:
- Infants with anatomically normal eyes may exhibit unresponsiveness to visual stimuli, suggesting cortical visual pathway dysfunction.
- Differentiating causes of visual unresponsiveness is crucial for timely intervention and management.
Observation:
- A cohort study evaluated 31 visually unresponsive infants and 31 controls using objective visual tests and neuroimaging.
- Infants were assessed for visual acuity, pattern visual evoked potentials (VEPs), and eye movements.
Findings:
- Developmentally normal infants with normal visual function were diagnosed with visual inattention (VI).
- Developmentally delayed infants with abnormal VEPs and/or neuroimaging findings were diagnosed with cortical visual impairment (CVI).
- Oculomotor apraxia (OMA) was identified as a contributing factor to apparent visual unresponsiveness in some infants.
Implications:
- Objective visual testing and neuroimaging can differentiate VI and CVI in infants.
- Early identification of VI, CVI, and OMA is possible through a combination of developmental status and specialized testing.
- This diagnostic approach aids in understanding cortical visual abnormalities in non-visually guided infants.
Related Concept Videos
01:24Vision
Vision is the result of light being detected and transduced into neural signals by the retina of the eye. This information is then further analyzed and interpreted by the brain. First, light enters the front of the eye and is focused by the cornea and lens onto the retina—a thin sheet of neural tissue lining the back of the eye. Because of refraction through the convex lens of the eye, images are projected onto the retina upside-down and reversed.
01:14Motor and Sensory Areas of the Cortex
The cerebral cortex, the brain's outermost layer, is pivotal in processing complex cognitive tasks, emotions, and various sensory inputs and executing voluntary motor activities. This intricate structure is divided into three primary functional areas: the motor areas, sensory areas, and association areas.
Motor Areas
The motor areas located in the frontal lobe are central to controlling voluntary movements. This region is further subdivided into the primary motor cortex and the premotor cortex.
Motor Areas
The motor areas located in the frontal lobe are central to controlling voluntary movements. This region is further subdivided into the primary motor cortex and the premotor cortex.
01:21Association Areas of the Cortex
Association areas are regions of the cerebral cortex that do not have a specific sensory or motor function. Instead, they integrate and interpret information from various sources to enable higher cognitive processes such as memory, learning, and decision-making. Some key association areas include the following:
Prefrontal Association Area: This area is located in the frontal lobe and is involved in planning, decision-making, and moderating social behavior. It connects with primary motor areas,...
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01:12Visual Agnosia
Visual agnosia is a condition characterized by the inability to recognize visually presented objects despite having normal vision. For instance, a person with visual agnosia can describe the shape and color of an object but cannot identify or name it. This impairment does not affect their visual field, acuity, color vision, brightness discrimination, language, or memory. An example of this condition in a social setting is someone at a dinner party asking for "that silver thing with a round end"...
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The sensorimotor stage, the initial phase of Jean Piaget's theory of cognitive development, spans the first two years of a child's life. During this period, infants actively engage with their surroundings, building cognitive awareness through direct interaction with the world. This interaction is primarily based on sensory perception and motor actions, allowing infants to gradually understand basic physical properties and predict how objects interact within their environment.
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01:21The Nativist Approach
The nativist approach to infant cognitive development proposes that infants are born with inherent knowledge structures that allow them to interpret the world almost immediately. This perspective contrasts with earlier developmental theories, such as those proposed by Jean Piaget, which emphasized a more gradual acquisition of cognitive abilities through interaction with the environment. One key concept in this approach is object permanence — the understanding that objects continue to exist...