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Updated: May 22, 2026
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An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Diagnosing cerebral visual impairment in children with good visual acuity
Maria van Genderen1, Marjoke Dekker, Florine Pilon
1Department of Ophthalmology, Bartiméus Institute for the Visually Impaired. mvgenderen@bartimeus.nl
Strabismus
|May 23, 2012
Summary
An abnormal medical history, particularly related to prematurity or perinatal hypoxia, is a key indicator for diagnosing cerebral visual impairment (CVI) in children. Other signs like cerebral palsy and visual field defects also support CVI diagnosis.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Cerebral visual impairment (CVI) diagnosis in children with good visual acuity presents diagnostic challenges.
- Identifying specific clinical indicators is crucial for timely and accurate diagnosis in general ophthalmic settings.
Purpose of the Study:
- To identify key clinical elements that facilitate the diagnosis of CVI in children with normal visual acuity.
- To differentiate CVI from other conditions in children with suspected visual impairment.
Main Methods:
- Retrospective investigation of clinical characteristics in 30 children with CVI and 23 controls.
- Evaluation included medical history, MRI, visual acuity, crowding ratio (CR), visual field, and ophthalmologic/orthoptic exams.
- Assessed the utility of a CVI questionnaire for diagnostic support.
Main Results:
- Abnormal pre- or perinatal history (e.g., prematurity, hypoxia) was present in 83% of CVI cases, versus 0% in controls.
- Cerebral palsy, visual field defects, and partial optic atrophy were exclusive to the CVI group.
- A crowding ratio (CR) ≥2.0 was observed in 41% of CVI cases, suggesting dorsal stream dysfunction; CVI questionnaires showed high false-positive rates.
Conclusions:
- An abnormal pre- or perinatal medical history is the strongest risk factor for CVI in children.
- Clinical signs such as cerebral palsy, visual field defects, partial optic atrophy, and a CR ≥2 support CVI diagnosis.
- CVI questionnaires are not recommended for screening due to excessive false positives.
