Visual Impairment

Forty to seventy five percent of children with cerebral palsy have a visual problem. [Black: 1980] Assessment of vision and interventions for visual impairment are an important component of care.

Problems may include:
  • strabismus: More than half of children with CP exhibit strabismus, a condition where the muscles that control eye movement are out of balance, causing the eyes to be misaligned. The misalignment of the eyes causes double vision, which the brain stops by turning off vision in one eye. In children this change can be permanent if the double vision is not corrected in the early years.
  • acuity loss: Acuity loss may be present by itself or with cortical visual impairment.
  • field defects: Field defects, especially homonymous hemianopsia and variants, are seen in hemiplegic cerebral palsy.
  • processing disorders (e.g., visual perceptual disorders, cortical vision impairment). Cortical vision impairment (CVI), which is caused by abnormal cortical processing of visual information is very common in children with CP. It can be hard to detect as the structure of the globe is normal, and children with CVI will exhibit normal pupillary reactions to light and normal eye movements, yet not respond to visual information. It is caused by hypoxia ischemia, developmental brain defects, and various insults to the brain such as infection and trauma. There is often substantial improvement over time.


Helpful Articles

Shafer, Stacy and Moss, Kate.
Cerebral Palsy and Children with Vision and Hearing Loss.
(1995) Accessed on 02/27/2005.
Summary of visual issues in children with cerebral palsy.

Blind Babies Foundation.
Cortical Visual Impairment Pediatric Visual Diagnosis Fact Sheet.
(1998) Accessed on 02/27/2005.
Article on cortical visual impairment which might be particularly helpful for families.


Author: Lynne M Kerr, MD, PhD - 10/2008
Content Last Updated: 5/2011

Page Bibliography

Black PD.
Ocular defects in children with cerebral palsy.
Br Med J. 1980;281(6238):487-8. PubMed abstract / Full Text