Cortical visual impairment in children: identification, evaluation and diagnosis.

PURPOSE OF REVIEW: Cortical visual impairment (CVI) is a major cause of visual loss in children worldwide. The definition of this condition is constantly evolving with respect to definition, identifying those at risk and technology for diagnosis. These advances can be used for early diagnosis, design of accommodations and services, as well as future therapies and prevention strategies.

RECENT FINDINGS: Clinical questionnaires are being developed and tested for reliability in an attempt to identify those at risk for CVI. The definition is constantly being modified and now includes deficits in vision-guided motor planning and higher level executive functions. Neuroimaging techniques, such as MRI, functional MRI, and diffusion tensor imaging; electrophysiologic testing, such as sweep visual-evoked potentials; and perceptual testing, allow for further refinements in correlating structural defects and deficits in function.

SUMMARY: Recent developments will allow identification of those children at risk for CVI and earlier interventions for specific deficits. A child's performance is built on previously mastered skills, making timely prediction of deficits and intervention essential.