Diagnosing CVI
You can make a CVI diagnosis if your patient 
meets the following criteria: 

1. The child has a neurologic condition affecting the 
visual pathways in the developing brain. 
2. There is visual dysfunction that cannot be explained 
by any ocular abnormality. 
3. The visual deficits involve visual acuity, contrast 
sensitivity, visual fields, and/or higher-order visual 
processing. 
4. The visual dysfunction cannot be explained by 
autism, dyslexia, or another disorder of learning, 
language, or social communication. 
History from parents or vision teachers that is 
suggestive of pediatric CVI: 


• 
The child interacts visually in a more focused way 
with an uncluttered workspace and lower sensory 
complexity. 
• 
The child prefers to gaze at light. 
• 
The child does not respond to people or large 
objects from across the room. 
Behavioral characteristics of CVI in children include: 


• 
Absent or clumsy visually guided motor response. 
• 
Preferential response to a flashing light toy or 
brightly colored object (usually yellow or red) with 
ocular following, smiling, or head/truncal 
movements. 
• 
Responds more vigorously with visual stimulation 
approaching from one side of the visual field or 
other. 
• 
Delayed response to visual stimuli; taking longer to 
fix and follow or to re-fixate to target in peripheral 
vision. 
• 
Looking up or away while looking at an object. 

Next stepsNext steps
Use additional assessments as needed to characterize 
visual deficits, rule out differential diagnoses, and 
evaluate underlying neurologic conditions. Suitable tests 
depend on 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 
Inform parents that with intentional, strategic 
interventions, there is an expectation of improved 
functional vision and provide resources like PCVIS, 
Perkins CVI Now, and CVI Scotland. 


Treat the ocular disorders as you usually do. 

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 
impairments. 

Write a parent letter with your diagnosis and 
recommendation that the child 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." 
Provide support to the family, referring to other 
specialties as needed. Children with CVI need 
eye/ocular assessments every 1-2 years at minimum for 
a periodic certification of diagnosis. Many pediatric 
ophthalmologists see young children with CVI every 6 
months. 


PCVIS is a 501(c)(3) nonprofit transforming outcomes for 
children with CVI by advocating for research, policy, 
education, practice, heightened awareness and 
understanding of this brain-based visual impairment. 

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