After a child receives a diagnosis of CVI, medical care doesn't stop—it evolves. Effective medical care after CVI diagnosis includes comprehensive assessments, thoughtful referrals, certification for visual impairment, and ongoing communication with families. Here are key steps medical professionals can take to ensure that children with CVI receive coordinated, informed, and compassionate care tailored to their unique neurological and developmental needs.

Post‑diagnosis assessments for CVI

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.

Monitor eye health. Look for changes in recovered visual function. As kids mature, you may be able to assess things that you couldn’t previously. It can be difficult to assess a child with multiple disabilities, and the way a patient responds to vision exams in a medical setting may not reflect their level of visual function in a well-known setting. 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 a 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.

The ophthalmologist must be an active and involved member of the team caring for a child with CVI. The ophthalmologist should provide diagnoses, referrals for services, treatment of ocular comorbidities, education, and advocacy for the patient. Interventions and accommodations allow the child with CVI to attain his or her fullest educational potential and maximize independence in activities of daily living.

A doctor examines the eyesight of a young boy with cerebral palsy, using a small flashlight. Credit: Jodi Mora Igual

Referral process after CVI diagnosis

Following diagnosis, a child should be referred for a vision services evaluation. According to the authors of Diagnosis and Care of Children with Cerebral/Cortical Visual Impairment: A Clinical Report, “CVI interferes with a child’s ability to access his or her educational materials providing medical necessity for vision services regardless of degree of disability.” Any pediatrician concerned about a child’s visual function may request a vision services evaluation before the patient has a formal diagnosis. For example, this might be helpful in a situation where the wait for a pediatric ophthalmology appointment is lengthy. (Lehman et al, 2024)

Provide a copy of your progress note or compose a letter to the parents with your diagnosis 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's visual and educational challenges will change over time.