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Closing in on a Consensus in Identifying, Assessing and Diagnosing Children With Cerebral Visual Impairment
Barbro Lindquist1,2,3, Christina Westerberg1,2
1Sahlgrenska Academy, Department of Ophtalmology, Sahlgrensk University Hospital, Gothenburg, Sweden.
Acta Paediatrica (Oslo, Norway : 1992)
|June 25, 2025
Summary
This review clarifies the definition and diagnosis of cerebral visual impairment (CVI) in children. It highlights the need for multidisciplinary teams and caregiver input for accurate assessment.
Area of Science:
- Pediatric Ophthalmology
- Neuroscience
- Developmental Pediatrics
Background:
- Global consensus on assessing cerebral visual impairment (CVI) is lacking, hindering research and diagnosis.
- CVI is a visual dysfunction not caused by anterior visual pathway disorders or co-occurring ocular conditions.
Purpose of the Study:
- To describe current consensus and evidence-based methods for identifying, assessing, and diagnosing CVI in children.
- To consolidate knowledge on CVI definition, assessment tools, and diagnostic approaches.
Main Methods:
- A data-based literature search of reviews and papers published between 2014 and 2023.
- Systematic review of seven reviews and 23 research papers.
Main Results:
- Confirmed CVI definition: verifiable visual dysfunction not attributable to anterior visual pathway disorders or ocular impairment.
- Dutton's CVI questionnaire identified as a relevant assessment tool.
- Diagnosis requires a multidisciplinary team, cognitive assessment, and caregiver/teacher collaboration. Neuropsychological testing including visual-perceptual skills is essential. MRI and ophthalmological exams are valuable but optional.
Conclusions:
- Sufficient evidence and consensus exist to develop general recommendations for CVI assessment and diagnosis.
- Highlights the importance of a comprehensive, team-based approach for diagnosing CVI in pediatric populations.
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