Cerebral visual dysfunction in prematurely born children attending mainstream school

Abstract

The prevalence of CVD in these prematurely born children is between 21-47 % (95 % CI), with a pattern similar to "dorsal stream dysfunction". Currently available perceptual tests appear to be unable to identify the specific pattern of problems noted in this group. Many studies have provided evidence of cognitive and intellectual dysfunction in prematurely born children, and it is possible that CVD is a contributor. The CVI inventory is a potential means of identifying and characterising the condition, which can be ameliorated with simple strategies.

A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children

“…In addition, with advances in medicine, white matter abnormalities have become less widespread and severe (23), which in turn might have resulted in a concomitant decrease of (severe) CVI. Our finding contrasts assumed visual rehabilitation needs for VP/VLBW children with CVI (16). Although the lack of visual service use might also reflect unmet needs, referrals to visual rehabilitation were not restricted by narrow acceptance criteria.…”

“…CVI-status was specifically accompanied by medium to large sized increases in parent-reported vision-related problems on the CVI Inventory, supporting the concurrent validity of our CVI concept. Other studies using different approaches found similar results in very preterm born children and among children referred to a CVI clinic (16,17). In addition, parent-reported visionrelated problems in VP/VLBW children with CVI remained largely present irrespective of selective and executive attention abilities, indicating that these visual problems exist independent of attention problems of very preterm born children (18).…”

Cerebral Visual Impairment in Children

“…(3) At the other end of the spectrum, perceptual visual dysfunction with normal or near normal visual acuities and abilities commensurate with mainstream education has also been described in relation to premature birth (Macintyre-Béon et al 2013 ). Such 'minor' degrees of perceptual visual dysfunction may not be uncommon but may be going unrecognised (Williams et al 2011 ).…”

“…More than half of the children (55 %) showed optic nerve atrophy; about two-thirds suffered from epilepsy. The relatively severe nature of the visual features described indicates that children with ostensibly perceptual visual dysfunction alone, that for example, may well be common but often undiagnosed sequel to premature birth (MacIntyre-Béon et al 2013 ), and may be not infrequent in the general population (Williams et al 2011 ), were probably not included in these studies. In two children without associated cognitive developmental disorders, CVI was caused by bilateral occipital cysts and by an occipital tumour, respectively, the latter being removed at the age of 2 years.…”

Impact of retinopathy of prematurity on ocular structures and visual functions

“…Differentiating the effects on vision of CVI and ROP can be difficult except when the retina is obviously disorganised. CVI encompasses a wide range of effects from blindness through to visual neglect and simultanagnosia (inability to process a crowded scene) 33. The latter may not be detected by routine clinical assessment such as visual acuity measurement, requiring specific questions to elicit difficulties in visual perception.…”