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Updated: Oct 5, 2025
A Method to Quantify Visual Information Processing in Children Using Eye Tracking
Published on: July 9, 2016
Ocular and cerebral causes of visual impairment in young children and a new scoring system to evaluate visual
Pınar Bingöl-Kızıltunç1, Esra Şahlı2, Ömer Bektaş3
1Department of Ophthalmology, School of Medicine, Ankara University, Ankara, Turkey. pinarbingol84@gmail.com.
Insights
Cerebral causes, like hypoxic ischemic encephalopathy (HIE), are common in childhood blindness. A new visual function scoring system helps objectively assess visual impairment and rehabilitation effectiveness in low vision children.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Childhood blindness significantly contributes to the global burden of visual impairment.
- Identifying prevalent causes of childhood blindness across diverse populations is crucial for targeted interventions.
Purpose of the Study:
- To characterize the clinical features of children with low vision.
- To evaluate factors influencing visual function using a novel scoring system.
Main Methods:
- A cohort of 249 children (6 months to 3 years) was assessed.
- Visual function was scored (0-15) based on responses to visual stimuli and fixation abilities.
- Patients were classified by neurological diagnosis and MRI findings, correlating these with visual function scores.
Main Results:
- Cerebral visual impairment (CVI) affected 54.6% of children, while ocular pathology was present in 35.7%.
- Hypoxic ischemic encephalopathy (HIE) was the most frequent cerebral cause (27.5%), and oculocutaneous albinism the most common ocular cause (23.9%).
- Children with CVI, neurological disorders, and HIE exhibited poorer visual function; widespread brain involvement and seizures further diminished visual capacity.
Conclusions:
- Cerebral etiologies account for nearly half of the low vision cases in children referred for habilitation.
- The developed visual function scoring system offers an objective tool for monitoring progress and evaluating the efficacy of visual habilitation programs.
Purpose:
Childhood blindness is important cause contributing to the burden of blindness. It is necessary to identify the most frequently observed diseases in different populations. We aimed to demonstrate clinical features of low vision children and to evaluate the factors affecting visual function by a new visual function scoring system.
Methods:
Two hundred forty nine children between the age of 6 months and 3 years were included. Visual function was scored from 0 to 15 according to; response to threat, light, object, presence of fixation, duration of fixation, following of light and object in horizontal, vertical, oblique, and circular gazes, optokinetic nystagmus. Patients were classified according to neurological diagnosis and cranial magnetic resonance imaging findings. Correlation between visual function score and ocular and neurologic findings were evaluated.
Results:
While 136 patients (54.6%) had cerebral visual impairment (CVI), 89 (35.7%) had ocular pathology, 24 patients (9.6%) had combined pathology. The most common ocular and cerebral pathologies were oculocutaneous albinism (23.9%) and hypoxic ischemic encephalopathy (HIE) (27.5%), respectively. Patients with CVI had lower visual function than ocular pathologies. Neurological structural disorders and HIE had worse visual function. Widespread involvement of brain had lower visual function score. Seizure negatively affected visual function.
Conclusions:
Cerebral causes were found in approximately half of infants and children with low vision who were referred to our center for visual habilitation. The visual function scoring system we developed in this study will provide an opportunity to be objective in the follow-up of babies and in evaluating the effectiveness of visual habilitation programs.
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