Visual Impairment: A Common Sequela of Preterm Birth

Improvements in survival rates of premature infants over the past several years have resulted in an increasing number of children with brain injury. Cerebral visual impairment (CVI) is among the most common sequelae of a preterm birth and usually arises from hypoxic ischemic injury to watershed areas of the brain. The term was introduced by Whiting more than 20 years ago to replace the inappropriate term “cortical blindness” used to describe permanent visual impairments in adult patients. CVI includes all visual dysfunctions “caused by damage to, or malfunctioning of, the retrogeniculate visual pathways (optic radiations, occipital cortex, and associative visual areas) in the absence of any major ocular disease.” The existence of many different causes and symptoms makes CVI difficult to define and detect, especially when a child exhibits milder forms of visual impairment that could contribute to difficulties with self-care and academic skills during school age. It is important for pediatricians to identify and recognize CVI as a common cause of visual developmental delay in children with premature birth or pre-, peri-, or postnatal insults because recognizing CVI early is the first step toward prevention and rehabilitation