Profiling Children With Cerebral Visual Impairment Using Multiple Methods of Assessment to Aid in Differential Diagnosis

International audienceCerebral (cortical) visual impairment (CVI) is the primary cause of visual impairment in children in high-income countries. It is increasing globally due to improved life-saving measures for premature and full-term infants. Yet the consequences of this condition are only beginning to be understood and addressed. In contrast to visual impairment due to refractive error and disorders of the eye, there is limited public awareness of CVI, and the consequent impairment of a variety of visual capabilities may go unidentified, adversely affecting cognitive, motor, and social development. CVI refers to visual perception deficits not related to the peripheral (i.e., prechiasmatic) system disorder, but rather, to injury to brain areas serving assimilation, integration, and interpretation of visual information. According to the topography, site, and the extent of the pathology, the deficit may variably concern central visual functions, the visual field, perception of movement, visual analysis, visual exploration and attention, or visual memory, as well as visual guidance of movement. Each affected child has a unique clinical picture, which needs to be identified and individually profiled. This is probably the underlying reason that CVI is commonly underdiagnosed, especially in children, and, as a consequence, the full range of potential behavioral outcomes are not identified and adequately addressed. The present paper shows how the use of multiple methods of assessment can improve the understanding of children with CVI