Cerebral/Cortical Visual Impairment in Primary Care: Extending the Evidence to Family Medicine

Introduction Cerebral/cortical visual impairment (CVI) is a leading cause of childhood visual impairment but remains underrecognized. CVI-related education, awareness, and visual dysfunction screening practices among family medicine physicians remain poorly characterized. This study evaluated CVI education and awareness, visual dysfunction screening, and referral practices among family medicine physicians. This present study evaluated whether similar patterns extend to family medicine physicians. Methods Nebraska family medicine physicians completed an anonymous 60-question electronic survey assessing CVI education and awareness, screening for visual dysfunction in children with neurologic disease, referral practices, and intended use of hypothetical screening tools. Results Fifty-seven responses were analyzed, with varying response numbers for each question. Fifty-four (98.2%) respondents reported no CVI education during residency/fellowship, and 51 (92.7%) reported no CVI continuing medical education. Forty-three (78.2%) respondents also expressed interest in future CVI education. Fifty (92.6%) were unaware of CVI diagnostic criteria, and 38 (70.4%) respondents reported screening for visual dysfunction in children with neurologic disease in 25% of encounters or less. Intended use was greater for shorter hypothetical screening approaches. Referral pathways and reported specialist availability varied. Conclusions Family medicine physicians reported limited CVI education and infrequent visual dysfunction screening. These findings suggest that opportunities to improve CVI education and recognition may extend across primary care specialties. This study also underscores potential opportunities for future efforts to improve recognition of children who may warrant further evaluation for CVI.