One page summary: Cortical visual impairment (CVI)

In two sentences

Cortical visual impairment, or CVI, is vision loss caused by the brain rather than the eye. The eye can be perfectly healthy while the brain cannot make sense of the signal it receives. ¹

This is why a standard eye examination often comes back normal and a family is told their child's vision is fine, while the child still cannot find a toy on a cluttered floor. CVI needs a functional vision assessment, not only an eye health exam. ¹

The numbers, with their sources

• What is affected. The visual pathways and the visual processing areas of the brain, not the structures of the eye ¹
• Why the eye exam is normal. An eye examination checks the health and focusing of the eye. It does not test whether the brain can interpret the image ¹
• Common causes after birth injury. Hypoxic-ischemic encephalopathy, periventricular leukomalacia, prolonged low blood sugar, stroke, bleeding and infection ²
• The hallmark feature. Vision that varies. The same child sees more on some days, in some settings, and at some times of day than others ¹
• What helps most. Changing the environment: reducing clutter, increasing contrast, presenting one item at a time and allowing extra time to look ¹
• Why it matters for school. CVI affects how a child accesses every visual task, so it belongs in the written education plan, which federal rules require to describe how a disability affects participation ³

What to do this week

1. Ask directly: "Has my child been assessed for cortical visual impairment?" Use those words.
2. Ask for a functional vision assessment, not just an eye exam.
3. Try one change today: put a single toy on a plain blanket and watch what happens.
4. Film your child looking, in a plain setting and a busy one, and bring the videos.
5. Ask for a teacher of the visually impaired through early intervention or the school.
6. Ask what the MRI showed in the occipital lobes and visual pathways.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the ophthalmologist

• Is there anything wrong with the eye itself?
• Does the eye exam explain what we are seeing at home?
• Could this be cortical visual impairment?
• Who does functional vision assessments here?

For the vision teacher or CVI specialist

• What specifically helps my child see better?
• How much looking time does my child need?
• What should the classroom look like?
• How will we measure whether vision is improving?

For the neurologist

• What did the MRI show in the visual pathways and occipital lobes?
• Could seizures be affecting vision?
• Is there a visual field loss?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Cortical visual impairment (CVI)

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.