www.clinophthaljournal.com 007 https://doi.org/10.29328/journal.ijceo.1001043
Research Article
Profiling children with cerebral visual
impairment in a tertiary eye care center
Addisu Worku Teshome* and Martha Degefu Worku
Department of Ophthalmology, College of Health Science, School of Medicine, Addis Ababa University,
Addis Ababa, Ethiopia
More Information
*Address for Correspondence:
Addisu Worku Teshome, MD, Assistant Professor
of Ophthalmology, Department of Ophthalmology,
College of Health Science, School of Medicine,
Addis Ababa University, Addis Ababa, Ethiopia,
Email: addiaddu@yahoo.com
Submitted: February 20, 2022
Approved: April 06, 2022
Published: April 07, 2022
How to cite this article: Teshome AW,
Worku MD. Profiling children with cerebral visual
impairment in a tertiary eye care center.
Int J Clin Exp Ophthalmol. 2022; 6: 007-012.
DOI: 10.29328/journal.ijceo.1001043
ORCiD: orcid.org/0000-0002-4992-6520
Copyright License: © 2022 Teshome AW, et al.
This is an open access article distributed under
the Creative Commons Attribution License,
which permits unrestricted use, distribution,
and reproduction in any medium, provided the
original work is properly cited.
Keywords: Profile; Children; Cerebral visual
impairment
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Abstract
Background: Cerebral visual impairment (CVI) is a bilateral visual impairment that affects
children in all industrialized countries. It has become more common in low-income countries as
a result of the increased survival rates of children who suffer from severe neurological conditions
during the perinatal period. The purpose of this study was to determine the characteristics of
children with CVI in a tertiary children’s eye care center population.
Methods: From October 2020 to September 2021, a cross-sectional study was conducted to
select all consecutive patients with a diagnosis of cerebral visual impairment aged 6 months to 16
years. On the neurological deficit, information was gathered from the patient’s referral: parental
interviews, observations, and direct assessment were used for functional vision characteristics,
and an ophthalmic examination was performed for eye findings. The interviewees’ responses
were matched to the ten specific behavioral characteristics shared by children with CVI. Cortical
visual impairment was diagnosed using three criteria: [the vision loss is not explained by
abnormalities found on the eye examination, a neurological medical diagnosis, and the child
exhibits one of the unique visual and behavioral characteristics described by Roman Lantz]. A
descriptive statistical analysis (frequency, mean, and range) was calculated.
Results: Forty children with CVI (1.96% of total children) were seen. The mean age was
2.56 ( 1.98) years. There were 24 (60%) males. On a referral paper of 28, hypoxic-ischemic
encephalopathy was the commonest cause mentioned (70.0%). Seizures were the most frequent
neurological deficit at presentation. Ophthalmic and neurologic impairments were found in 42.5%
of children with CVI. Based on Roman-Lantzy’s three phases of the CVI Range, 90% of children
with CVI at the test time had Phase I or Phase II vision.
Conclusion: According to the findings of this study, visual impairment is critical in the
diagnosis of CVI. The prevalence of CVI as a cause of childhood vision impairment is significant.
Hypoxic-ischemic encephalopathy is the most common cause of CVI. All children with CVI have
serious neurological issues, and the majority have associated ophthalmic abnormalities.
it is not a consciously symptomatic condition, many affected
children go unidentiϐied [5]. Indeed, the most common causes
and associations with CVI are cerebral anoxia (or hypoxia) and
periventricular leukomalacia [6,7]. It can also occur as a result
of meningitis [8], encephalitis [9], traumatic brain injury
[10.11], hydrocephalus [12], or metabolic abnormalities [13].
A child with CVI may have a normal to near-normal ability
to detect details in what he or she sees, but the child may be
completely unaware of what he or she is seeing [14]. Early
brain damage is frequently diffuse and affects multiple brain
functions, resulting in concomitant neurological disorders
such as seizures, intellectual disability, and cerebral palsy,
which may exacerbate the detrimental effects of CVI on
cognitive, motor, and social development [9,15].
Introduction
Cerebral visual impairment (CVI) refers to a broad range
of bilateral visual and perceptual impairments caused by
dysfunction, anomaly, or injury to the brain’s retinogeniculate
visual pathways and centers, speciϐically the optic radiations,
occipital cortices, and visual associative areas, in any
combination or degree, and oculomotor control, which is
more profound if the thalamus is affected [1,2]. Cerebral
visual impairment, which is already the leading cause of low
vision in children in developed countries, is becoming more
common in low-income countries as medical technology
improves the survival of children who suffer from severe
neurological conditions during the perinatal period [3,4]. CVI
has the potential to affect at least 2.4% of children [5]. Because