6392 Assessing strengths and weaknesses in cortico visual impairment care delivery pathway in a tertiary care centre, Sri Lanka

Objectives General – To asses the strengths and weaknesses of Corticovisual impairment (CVI) care delivery pathway Specific - To asses the risk factors for CVI To identify the lag period of CVI diagnosis to treatment To identify the factors that affect the care delivery pathway. To identify the sociodemographic, patient, family and service organisation factors limiting the care delivery pathway Methods A descriptive cross-sectional study was conducted among a convenient sample of 100 children diagnosed with CVI and attending for routine pediatric neurology care at Lady Ridgway Hospital for Children, Colombo, Sri Lanka Data were collected from the care giver using an interviewer-administered questionnaire and relevant medical information was extracted from medical reports. Results Risk factors- 80% prematurity, 10% hypoxic ischemic encephalopathy, 5% neonatal sepsis, 5% other. All the children had development disorders. 64%had seizures Age at diagnosis – 76% in infancy 24% after infancy Diagnosis to treatment commencement delay was 3 months- 89% Referral for therapy – 70% following eye assessment. 30% direct referrals of at risk babies All the children were looked after by their mothers. 69% of the mothers were educated up to GCE Ordinary Level exam only. All of them had home modifications which are CVI friendly. 64% children received daily home based therapy. But 84% of them spent less than 30 minutes per day. All the parents who brought their children for therapy were satisfied with treatment offered by the therapist. Only 62% of parents had an understanding of nature of CVI Conclusion Strengths Early diagnosis during infancy Satisfaction in therapist and belief in improvement with continued therapy. Maternal (care giver) education level Home modification Areas in need of improvement High degree of suspicion in at risk babies and immediate referral to commence visual rehabilitation once diagnosed. Involvement of other family members Awareness campaigns to improve care giver knowledge and reduce social stigma Improving socio-economic support References Multidisciplinary guidelines for diagnosis and referral in cerebral visual impairment. Frontiers in human neuroscience, 30, June 2022. doi.org/10.3389/fnhum.2022.727565. Guidelines of determining the frequency of services to support learners with CVI. https://cviconnect.co/guidelines-for-determining-the-frequency-of-services-to-support-learners-with-cvi/. Sarah W Blackstone. Children with corticovisual impairment and communication needs: identify gaps between needs and current practise. https://pubs.asha.org/doi/10.1044/2020_LSHSS-20-00088.