CVI Fact Sheet 
Teacher of Students with Visual Impairment 
What is Cortical Visual Impairment? 

Cortical Visual Impairment (CVI) is a congenital or acquired brain-based visual impairment which is unexplained 
by an ocular disorder and associated with unique visual and behavioral characteristics. 

A child has CVI when: 

• The visual loss cannot be fully explained by an 
eye exam. 
• There is a history of a neurological condition or 
traumatic event that affects the brain — even if 
brain imaging studies appear normal. 
• The child demonstrates a set of unique visual 
and behavioral characteristics identified in 
medical and educational research. 1, 2 


Behaviors commonly associated 
with CVI: 

• Difficulty using eyes and hands together 
• Difficulty looking at and reaching for toys 
• Difficulty with fine motor and visual motor skills 
at the same time (look, look-away, reach 
pattern) 
• Overly attracted to lights 
• Tendency to respond to sound or an auditory 
stimulus, rather than to visually regard and see 
a target 
• Difficulty finding objects in a visually complex 
environment, such as the grocery store or 
playground 
• Head turns more frequently toward one visual 
field 
• Difficulty making eye contact or recognizing 
familiar faces 
• Delayed or absent blink to touch and threat 
• Difficulty finding one's way around a building or 
community environment 
• Lack of visual curiosity 
• Novel objects and/or toys may not be 
regarded 


Children with CVI may also have coexisting 
ocular condition(s), but these conditions will not 
fully explain their functional visual difficulties. 

• Difficulty attending to targets (people, objects, 
classroom board) at far distances 
• Requiring the addition of light and


/or 
movement to elicit a visual response to a 
target
/object 
• Difficulty navigating through a crowded space, 
for example, child may freeze and stay in 
place, hold onto an adult, or move more quickly 
than is safe 
• May have difficulty with lower field visual 
regard, affecting navigation of stairs, curbs and 
terrain changes, playground slides, and notice 
of objects on the ground 
• Difficuly recognizing, discriminating, and


/or 
identifying images or objects; confusing targets 
that are similar to others, for example, labeling 
all four-legged animals as the same animal 
What are the most common causes of CVI? 

Children with CVI have a history of a medical 
condition that disrupted the brain's visual 
pathways before, after, or around the time of 
birth. Perinatal conditions that cause CVI include: 

• Perinatal hypoxia 
• Hydrocephalus 
• Traumatic brain injury 
• Congenital infections such as cytomegalovirus 
• Intraventricular hemorrhage 
• Periventricular leukomalacia 
• Genetic disorders 
• Stroke 


For more information, visit P

CVIS at 

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


What can you do if you suspect CVI? 

• Refer the child to an ophthalmologist, neurologist, 
neuro-ophthalmologist, or optometrist. 
• Communicate with the physician and/or give parents 
specific language to discuss with the physician. 
• Complete the CVI Range© which includes Interview, 
Observation, Direct Assessment. 1 
• Implement intentional goals and interventions based 
on the CVI Range score. 1 
• Develop a CVI Schedule to allow the child visual 
access throughout the day. 1 


What is the TVI’s role? 

• Know the risk factors for CVI. 
• Know the diagnostic criteria for CVI. 
• Know the three Phases of CVI. 1, 2 
• Conduct the CVI Range. 1 
• Write IEP goals based on the CVI Range Rating I. 
• Write intentional interventions for each of the nine 
characteristics that are not resolved in Rating II. 
• Communicate with family and team members 
regarding the child’s CVI Range score and how it 
impacts his or her functional vision. 
• Plan for visual access throughout the child's day with the 
appropriate level of support and the CVI Schedule. 


1, 2 

Know the 10 Characteristics of CVI 

Difficulty With Visual Novelty 

Children with CVI seem to prefer to visually regard targets 
that they have viewed over and over and, conversely, 
appear to ignore objects or other targets that are new. 

Need For Movement 

The child may be attracted to objects that have properties 
of movement over those that remain stationary, including 
shiny, reflective surfaces that create the illusion of 
movement. 

Absence of Visually Guided Reach 

Many children with CVI are unable to look and reach 
simultaneously. Some may localize or fixate on a target, 
turn away, and then reach in the direction of the target. 

Difficulties With Visual Complexity 

Visual complexity encompasses four interrelated aspects: 

Complexity of patterns on the surface of objects 

Children with CVI in general appear to have the most 
consistent visual responses to objects with simple 
patterns or color on their surfaces. 

Complexity of visual array 

Most children with CVI have ocular abilities that allow 
the reception of visual information. Often, however, 
visual information may be seen but cannot be sorted, 
interpreted, or understood. 

Complexity of sensory environment 

Visual attention can occur only when there are no 
distractions from other sensory stimuli. Many with CVI 
may be unable to establish or maintain visual attention 
when there is competition from other sensory inputs. 

Complexity of visual elements of human faces 

Children with CVI often demonstrate unusual regard of 
faces. Eye-to-eye contact is generally absent. As 
functional vision increases, the child with CVI may begin 
to discriminate faces in a slow and predictable way. 

Color Preference 

The child may have a strong attraction to visual targets of a 
particular color. Even when there is not a single, preferred color, 
the use of color is critically important. Vibrant or highly 
saturated color alerts and maintains visual attention to a target. 

Visual Latency 

The child's visual responses may be slow or frequently delayed, 
which may include a delay in recognition or interpretation. 
However, if sufficient wait time is permitted, the child may 
eventually turn in the direction of the target and localize (turn 
toward) or fixate (eye-to-object contact) on the object. 

Visual Field Preference 

The child may ignore information presented in certain areas of 
their visual field, or they may turn their heads to view objects 
from a particular portion of their field of view. Visual field 
preferences are present in almost all children who have CVI. 

Need for Light 

The child may exhibit unusual attraction to or need for light, and 
may spend prolonged periods of time gazing at primary sources 
of light, whether natural light or artificial light. 

Difficulty With Distance Viewing 

Many children with CVI who have difficulty with distance 
viewing behave as though they were highly nearsighted. The 
child may position his or her face within inches of a visual target 
and have great difficulty recognizing even familiar or large 
targets when they are presented beyond the immediate vicinity. 
This characteristic is closely linked to the characteristics of 
difficulty with complexity of array. 

Atypical Visual Reflex Responses 

Many children with CVI tend to have atypical responses with 
regard to two innate reflexes that serve to protect the eyes 
from potential harm: the visual blink reflex and the visual threat 
response. Assessment is of reflexes but they are not part of an 
intervention protocol or program as they are not directly 
influenced by instruction. 

1 Roman-Lantzy, C. (2018). Cortical Visual Impairment: An Approach to Assessment and Intervention.
2 Roman-Lantzy, C. (2019). Cortical Visual Impairment: Advanced Principles. Louisville, KY: APH Press. 
2nd ed., New York, NY: AFB Press.