Cerebral Visual Impairment Treatment

Cerebral Visual Impairment Treatment

Ara Damansara Medical Centre the first private hospital in Malaysia to offer management and treatment of Cerebral Visual Impairment. Cerebral visual impairment (CVI) is a disorder caused by damage to parts of the brain that processes vision. It’s most common in babies and young children but can continue into adulthood.

What you need to know:

Signs & symptoms that you should recognise:

  • Preference for a specific color
  • Need or preference for movement.
  • Delayed response when looking at objects (visual latency)
  • Difficulty with visual complexity.
  • Light-gazing and non-purposeful gazing
  • Visual field preferences
  • Distance vision impaired
  • Visual blink reflex is absent or impaired
  • Preference for familiar object
  • Impaired visually guided reach

Treatment modality

We can help you understand how your child sees the world. Our inter-disciplinary team comprising of Consultant Ophthalmologists, Rehabilitation Physicians, Optometrists and Occupational Therapists come together to assist you to help your child enjoy his / her growth through play and learning.

Frequently Asked Questions

What is cerebral visual impairment?
Cerebral visual impairment (CVI) is a brain-based visual condition.
It impacts the visual pathways (which brings information from the eye through the brain) and the visual processing centers (the places in the brain that help you locate, attend and understand what you see).
How common is CVI?
It’s most common in babies and young children, but can continue into adulthood.
What causes CVI?
CVI is caused by an injury to the brain. Most of the time, these injuries happen before, during, or shortly after birth. Common causes of CVI in babies and young children include:
  • Lack of oxygen or blood supply to the brain — often because of a stroke
  • Hydrocephalus (when fluid builds up in the brain)
  • Periventricular leukomalacia, a brain injury that affects preterm infants that causes the death of brain tissue
  • Traumatic brain injuries
Babies who are born prematurely (early) are more likely to have CVI.
What are the symptoms of CVI?
Kids with CVI may have trouble:
  • Responding to the things they see
  • Seeing certain parts of what is in front of them, like busy moving scenes
  • Recognizing faces and objects
  • Recognizing things in cluttered spaces
  • Reaching for something while they’re looking at it
  • Understanding what they’re looking at
Parents may also notice that their child with CVI:
  • Reacts slowly to visual cues
  • Tends to stare at light
  • Prefers to look at things that are moving (e.g.: ceiling fan)
  • Prefers to look at things in a certain part of their vision, like with their peripheral (side) vision
How is CVI diagnosed?
A CVI diagnosis is an abnormal visual behaviors that cannot be explained by the clinical eye exam. It is typically diagnosed by a pediatric ophthalmologist and neurologist who understands the visual behavior of CVI seen in an office visit. The child will be further assessed by optometrist; and occupational therapist will be responsible in conducting the needed therapy.
How is the CVI assessment like?
Approach of Assessment
  1. Interview
  2. Observation
  3. Direct evaluation of children
Interviews
  • Interviews (using 25 questions) with parents/caregivers.
  • Includes full medical history and birth history; developmental history; and educational history
Observation
  • Children are observed throughout the evaluator's time with the child, beginning with the initial contact.
  • Visual behavior needs to be observed in a variety of settings and circumstances.
  • Kids with CVI display many characteristic behaviors referred to as “visual behaviors”.
Direct Assessment
  • Consists of systematic presentation of visual stimuli that would be expected to evoke behavioral responses typical of CVI, and then noting the student's response.
What is the treatment for CVI?
There is no cure for CVI. However, early intervention and assessment can help address your child’s vision sooner.
The CVI assessment will determine what your child's visual abilities are and create learning environments and materials that helps your child to build visual attention and begin to recognize the world around them.
Our occupational therapist will also create customized learning and play programs to suit your child.
What is the process for CVI treatment in ADMC?
After the child diagnosed by our ophthalmologist, our optometrist will do the 1st assessment on the child to see the CVI range needed for the therapy. There will be a total of 6 sessions of therapy which will be conducted by our occupational therapist. After all the therapy sessions done, there will be another post-assessment done by our optometrist again to see the CVI range again. We will advise your child to continue the therapy if necessary.
What are other places that offer CVI treatment?
Up to this date, only ADMC and Hospital Kuala Lumpur (HKL) offers this service.
ADMC is the first private hospital to offer this service.

References:

https://www.perkins.org/cvi-now/understanding-cvi/how-is-cvi-diagnosed
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cerebral-visual-impairment-cvi

For an assessment, make an appointment with a Paediatric Ophthalmologist or a Paediatric Neurologist at ADMC.