Cortical visual impairment is reduced vision due to damage or dysfunction in the visual pathways of the brain, not the eyes themselves. It is a leading cause of childhood visual impairment in developed countries.
Features and causes
Ocular examination may appear relatively normal.
- Inconsistent visual responses and difficulty with complex scenes
- Perinatal hypoxic-ischaemic injury, infections, or brain malformations as common causes
- Coexisting motor, cognitive, or seizure disorders
- Neuroimaging often shows parietal-occipital damage
Management
There is no simple cure, but visual function can often improve with support.
- Early referral to low-vision and developmental services
- Environmental adaptations: high contrast, simplified backgrounds, and controlled lighting
- Regular ophthalmic monitoring for refractive errors or strabismus
- Close collaboration with neurology, physiotherapy, and education teams
