Cortical Visual Impairment 

Important information:

Cortical visual impairment (CVI) is a brain-based condition where the eyes take in visual information, but the brain has trouble processing and interpreting what it sees. It is the leading cause of visual impairment in children. Children can have a normal eye exam but still have CVI. CVI is usually diagnosed by an ophthalmologist (eye specialist). However, a professional, who has additional training specific to CVI, can observe your child and assess the severity of the CVI.

What will a healthcare provider look for to diagnose CVI? 

  • A medical condition that involves the brain  

  • A normal eye exam OR an eye exam that does not explain why a child has trouble using their vision 

  • Unique CVI visual behaviors that may include: 

    • Staring at lights 

    • Staring at fans or other moving objects 

    • Difficulty focusing on faces 

    • Decreased interest in books 

    • Becoming upset or falling asleep in noisy places 

    • Staring into space 

    • Difficulty finding dropped objects  

    • Prefers to look to one side

    • Delays looking at toys or objects that are shown to them

    • Challenges with reaching or reaching and looking at the same time

What medical conditions put children at risk for CVI? 

Any medical condition that has brain involvement places a child at risk for CVI. Examples include: 

  • Hypoxic ischemic encephalopathy (HIE) 

  • Intraventricular hemorrhage (IVH) 

  • Periventricular leukomalacia (PVL) 

  • Stroke  

  • Trauma  

  • Congenital abnormalities  

  • Infection

  • Metabolic disorders  

  • Chromosomal disorders  

  • Seizures  

How can I help my child if they are showing behaviors of CVI? 

A child with known or possible CVI would benefit from a vision test called the CVI assessment. The results of this test can help to: 

  • Provide additional information to physicians who can confirm a diagnosis 

  • Determine how much CVI has affected your child’s visual function 

  • Determine what types of vision support your child needs

Where can I get CVI Range testing for my child? 

  • There are occupational therapists at CHOP who can complete the CVI assessment, including the CVI Range. Ask your therapist or provider for a referral. CVI assessment can be done at our Buerger or King of Prussia locations. It is only available for children who are nine months and older. 

  • Once you have a referral, call 215-590-5819 and ask for a CVI Evaluation. Schedulers will assist in setting up your appointment. 

Instructions to improve your child’s vision:

  • Minimize background noise and distractions. This will encourage your child to use vision more than hearing. 

  • Lower your voice. 

  • Turn off the TV or music.

  • Encourage quiet behaviors from other caregivers or providers in the room. 

  • Reduce the amount of touching you provide when trying to visually engage your child. This can be distracting and disrupt a child’s ability to use their vision. 

  • Use black surfaces (sheets, towels, placemats) as play surfaces. Block out busy visual backgrounds. 

  • Turn your child away from sources of light, such as windows, computer screens, and lamps. 

  • Choose toys that are a solid, bright color. Red and yellow are usually the easiest to see. 

  • If your child prefers to look to one side, show them toys there first. 

  • Gently move a toy or object movement as that can help elicit and sustain a child looking at an item. 

  • Use light-up toys or shiny material (such as pinwheel, shiny pom-poms, neon slinkies) to get your child’s attention. 

  • Ask your therapist how you can best position your child to support their vision.

Please contact your occupational therapist if you have any questions or concerns.

 

Reviewed November 2025 by Kelly Seibert, MS, OTR/L