Medical Professionals

What Can the Doctor Do After Diagnosing CVI?

Inform parents that with intentional, strategic interventions, there is an expectation of improved functional vision.

Use additional assessments as needed to characterize visual deficits, rule out differential diagnoses, and evaluate the underlying neurologic conditions. Suitable tests depend on the child's age, level of vision, and cognitive ability, such as:

    • Structured history-taking questionnaires for CVI
    • Preferential looking tests of visual acuity and contrast sensitivity
    • Perimetry
    • Electrophysiology (electroretinography and visual evoked potentials)
    • Neuroimaging
    • Genetic testing
    • Neuropsychological assessments of visual perception

Treat the ocular disorders as you usually do. Strabismus, refractive errors, accommodative insufficiency, amblyopia, cataracts, etc.

Certify the child as being “legally blind” or “visually impaired” due to neurological disorder under ICD-10 H47.61 Cortical Blindness. This will qualify the child for state-funded services for children with visual impairment.

Provide a copy of your progress note or compose a letter to the parents with your diagnosis of cortical visual impairment and complete examination findings, including a descriptive visual acuity. In your recommendations state: The child should receive “assessment and intervention for CVI by a Teacher of Students with Visual Impairment, Orientation and Mobility Specialist, and other therapists who are knowledgeable about CVI. This should include a CVI-specific functional vision assessment.” Direct the parents to provide a copy of the report and certification of diagnosis to the child’s school administration or agency providing services. Remember that the child and his/her visual/educational challenges will change over time.

Individualized Family Service Plan (IFSP)

Children up to age 3 who have a disability may be eligible for early intervention services provided through an Individualized Family Service Plan, or IFSP, under Part C of the Individuals with Disabilities Education Act

Individualized Education Plan (IEP)

Children with a disability that interferes with education who attend a school with federal funding may qualify for an individualized educational plan, or IEP, under the Individuals with Disabilities Education Act

Provide resources to the parents  and ask, “What do you need for your IFSP or IEP?” Here are some resources for parents of newly diagnosed children. 

Monitor eye health. Look for changes in recovered visual function. As kids mature, you can assess things you couldn’t previously. Advise parents that you will stay engaged with the child or refer them to an eye care provider who will. Children with CVI need eye/ocular assessments every one to two years at minimum for a periodic certification of the diagnosis. Many pediatric ophthalmologists see young children with CVI every six months. Refer the patient to other specialties as needed.

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