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Cerebral Visual Impairment

vision4children’s second research project is concerned with developing more streamlined diagnosis and targeted support for children whose visual impairment is reflected through their eye and vision due to a problem with the “seeing” areas of their brain (where signals from the nerves in the eye are processed). This is called Cerebral Visual Impairment (CVI) and usually occurs at or just before or just after birth due to lack of oxygen to the brain – especially in children born prematurely.

 

The diagnosis for assessment of structural damage in the brain and vision areas is via either MRI or CAT scans. These tests which do not reveal details of location of damage or the precise effect within the brain that the problem is having, or indeed the child’s experience of the real world – so children’s problems from their CVI are not being addressed.

 

To make matters worse, a child who has been diagnosed with Cerebral Visual Impairment will be seen individually by many different medical professionals:

  • Ophthalmologists
  • Optometrists
  • Orthoptists
  • Occupational Therapists
  • Neurologists
  • Vision Scientists and
  • Clinical Psychologists (who often work independently of any other team involved).

There exists no joined up approach in their treatment and for many children there are no systems of assessment of their difficulties in place at all. Currently there is maximum family disruption for little corresponding benefit.

 

v4c believes that decisive action is needed now. In January 2014, along with our international collaborators at Stanford University, USA we began developing a package of gold standard tests of visual function and improved methods of looking at MRI scan results to assess structural damage. We will be able to precisely measure a child’s visual function in the real world using Visual Evoked Potential (which measures the electrical impulses within a brain as it responds to different stimuli). We will also look at MR scans and analyse the precise location of structural damage with modern analytical techniques. These tests are far more accurate than anything we have so far. Diagnosis and an assessment of their difficulties can be made more quickly, cheaply and accurately.

 

This ‘structure-function study’ can be used to assess the effectiveness of the prescribed treatment package and agreed future steps.

 

The project will work towards implementing these tests in routine clinical practice over the next two years allowing many more children to reach their full potential.