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A Method to Quantify Visual Information Processing in Children Using Eye Tracking
Published on: July 9, 2016
Identification of Suspect-Cerebral Visual Impairment in Children with Special Needs: Moving Towards an Inclusive
Rachel F Pilling1, Sidra Amjad1
1University of Bradford, UK.
Insights
Cerebral Visual Impairment (CVI) in children is often identified by atypical responses in multiple visual assessment domains. Atypical eye movements, visual field, or visual attention are key indicators for referral to CVI diagnostic pathways.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Cerebral Visual Impairment (CVI) is the leading cause of vision impairment in children in developed nations.
- Many children in special education exhibit atypical visual function, but clear referral criteria for CVI assessment are lacking.
- Identifying children who require further investigation for CVI is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To define elements of visual function assessment that may indicate a threshold for referral to CVI diagnostic pathways.
- To examine patterns of visual assessment outcomes suggestive of CVI in children with special needs.
- To establish referral criteria for suspected Cerebral Visual Impairment.
Main Methods:
- Retrospective analysis of 50 children's records from a specialist visual assessment clinic.
- Documentation of visual abilities including acuity, contrast sensitivity, visual field, eye movements, visual attention, accommodation, and optic disc appearance.
- Review of visual assessment outcomes to identify patterns associated with CVI suspicion.
Main Results:
- A diagnosis of CVI was associated with atypical responses in three or more tested visual domains.
- Children with CVI demonstrated a significantly higher mean number of atypical responses (4.2) compared to those without CVI (0.4).
- No significant difference was found in the number of completed test domains between children with and without CVI.
Conclusions:
- Atypical eye movements, visual field deficits, and/or impaired visual attention are critical indicators for comprehensive CVI assessment.
- Facilitating the identification and referral of children with CVI-related behaviors by eye health professionals is essential.
- An inclusive diagnostic approach for high-risk children with suspected CVI is paramount.
Introduction:
Cerebral Visual Impairment (CVI) accounts for most visual impairment in children in the developed world. A significant proportion of children in special needs education demonstrate atypical visual function, yet referral thresholds for onward assessments are not defined. We sought to describe the elements of a visual function assessment that might indicate a threshold for referral into CVI diagnostic pathways.
Method:
We undertook a retrospective analysis of 50 consecutive records of children attending a specialist visual assessment clinic. Visual ability was documented, including visual acuity, contrast sensitivity, visual field, eye movements, visual attention, accommodation, and optic disc appearance. The aim of this retrospective case note review was to examine the pattern of visual assessment outcomes that raised suspicion of CVI in a cohort of children with special needs.
Results:
Atypical response to three or more testing domains was associated with a diagnosis of CVI. Mean age of children was 6.6 years (range 1-16). There was no statistical difference in the mean number of test domains completed by those with/without CVI. (7.3 vs. 8.3; p = 0.5). Children with CVI showed a statistically higher mean number of atypical responses compared with non-CVI patients (4.2 vs. 0.4; p = 0.015).
Discussion:
Our findings are in keeping with other studies that indicate that detecting atypical eye movements, visual field, and/or visual attention play a key role in highlighting children who warrant comprehensive assessment for CVI. Facilitating eye health professionals to identify and refer on those children with evidence of CVI-related behaviors will further our endeavors to provide an inclusive approach to diagnosis in a high-risk group.
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