Cortical visual impairment in children

PURPOSE OF REVIEW: Cortical visual impairment is rapidly becoming a leading cause of visual loss in children in developed countries predominately because of the improved survival rates of premature infants over the past decade. RECENT FINDINGS: Most cases of cortical visual impairment arise from hypoxic ischemic injury to watershed areas of the brain. In the preterm infant the watershed areas are in the subcortex around the ventricles, while in the term infant the watershed areas are between the major arteries with injury to the subcortex and cortex. Therefore, preterm and term injury will manifest different ocular and visual system abnormalities as a result of this damage. Cognitive visual dysfunction, a type of cortical visual impairment, may occur in cases of damage to the peristriate cortex (association areas of the brain). The anterior visual pathways may also be damaged in a retrograde, transsynaptic fashion in cases of cortical visual impairment. SUMMARY: Cortical visual impairment is a prevalent cause of visual loss in children. It encompasses a wide range of visual disabilities from no light reception to normal visual acuity with cognitive visual dysfunction.