Visual impairment and cerebral palsy
One survey of nearly ten thousand children with CP across Europe between 1976 and 1998 found that around a third of the children had some visual impairment, and 10% had a severe visual impairment. It also found that children with hemiplegia were less likely to have visual impairments than those with more severe forms of cerebral palsy.
Early intervention for visually impaired children should begin as early as possible in a positive emotional setting that enhances the child’s motivation and relationship with their parents and carers. This will ensure significantly improved outcomes for the child.
View more information about early intervention for children with visual impairments, other guidance and sign posting for parents.
Types of visual loss in cerebral palsy
The main causes of visual impairment can be broadly divided into those related to the brain, and those related to the eye.
Cerebral (or Cortical) Visual Impairment (CVI) is caused by damage within the brain. This damage prevents the child from correctly receiving or interpreting information from their eyes. The difficulties of any child will vary depending on the amount and location of damage within the brain.
A child with CVI may have difficulties:
- knowing precisely where things are in three dimensions. This can make it difficult for the child to move around safely e.g. using stairs;
- seeing several different things at the same time - e.g. finding a toy on a patterned carpet or seeing something that is pointed out in the distance amongst other things;
- recognising familiar faces, objects and places.
They may also have problems with:
- focusing when looking at a close object;
- making fast eye movements;
- their eyes becoming 'tired' more quickly than other children’s. This means that their ability to see can vary from one time to another;
- visual field loss – which means that some parts of their field of vision can be missing or appear blurred.
CVI does not usually get worse and vision can sometimes improve over a period of time. However, even when there is some improvement, a child’s vision will usually remain impaired to some extent.
Treatment of CVI
There are currently no medical treatments for CVI. Instead efforts should be focused on managing the condition through the use of spectacles, contact lenses and other low vision aids.
Other possible causes of visual impairment in cerebral palsy
Some causes of visual impairment in children with CP relate to the eye itself. There are a number of conditions that occur more commonly in children with CP than the rest of the population.
Strabismus (squint) is a condition where the eyes point in different directions. One eye may turn inwards, outwards, upwards or downwards while the other eye looks forward. It can cause blurring of vision or amblyopia (lazy eye) – which is caused when the brain starts to ignore signals coming from the eye with the squint.
Common treatments for strabismus include glasses and eye exercises. If a child has a lazy eye, they may need to wear an eye patch for a few weeks to improve their vision in the affected eye. If these treatments aren't successful, corrective surgery may be required. This involves moving the muscles that control the movement of the eye.
Hyperopia (long-sightedness) - if a child is long-sighted, they will be able to see distant objects clearly, but nearby objects will be out of focus. Their eyes may also tire easily.
Treatment is often corrective, using either glasses or contact lenses. Several surgical techniques have also been developed to treat the condition. Laser surgery is sometimes used although it is not suitable for children.
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Reviewed: May 2015
Review due: May 2017
First published: Monday 24 June 2013
Updated: Tuesday 22 December 2015