Cortical/cerebral visual impairment (CVI) results from perinatal injury to visual processing structures and pathways of the brain and is the most common cause of severe visual impairment/blindness in children in developed countries. Children with CVI display a wide range of visual deficits including decreased visual acuity, impaired visual field function, as well as impairments in higher order visual processing and attention. Together, these visual impairments can dramatically impact upon a child’s development and well-being. Given the complex neurological underpinnings of this condition, CVI is often undiagnosed by eye care practitioners. Furthermore, the neurophysiological basis of CVI in relation to observed visual processing deficits remains poorly understood. Here, we present some of the challenges associated with the clinical assessment and management of individuals with CVI. We discuss how advances in brain imaging are likely to help uncover the underlying neurophysiology of this condition. In particular, we demonstrate how structural and functional neuroimaging approaches can help gain insight into abnormalities of white matter connectivity and cortical activation patterns respectively. Establishing a connection between how changes within the brain relate to visual impairments in CVI will be important for developing effective rehabilitative and education strategies for individuals living with this condition.

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The Pandemic of 2020 impacted conducting in-person research. Our proposed project already had an asynchronous online component but was later morphed to add a synchronous online component, thereby eliminating the need for in-person assessment. The project compares the results of various tests between a group of children with Cerebral Visual Impairments (CVI) (N = 4) and an age-matched sample of children without CVI (N = 3) from a pediatric low vision clinic. This model was trialed with a small convenient sample of typically developing children in the same age range (N = 4). Given the positive feedback, recruitment for the larger study was done via encrypted e-mail rather than through traditional mailing. The asynchronous components included recruitment, pre-assessment information, the Flemish CVI questionnaire, Vineland-3 comprehensive parent questionnaire for assessment of age equivalent, and vision function tests, such as contrast sensitivity. The synchronous components were administered via Zoom telehealth provided by necoeyecare.org and included assessment of visual acuity via the Freiburg Visual Acuity and Contrast Test (FrACT) electronic software and assessment of visual perceptual batteries via the Children’s Visual Impairment Test for developmental ages 3–6-years (CVIT 3–6). Our virtual testing protocol was successful in the seven participants tested. This paper reviews and critiques the model that we utilized and discusses ways in which this model can be improved. Aside from public health considerations during the pandemic, this approach is more convenient for many families. In a broader perspective, this approach can be scaled for larger N studies of rare conditions, such as CVI without being confined by proximity to the researcher.