Closing in on a Consensus in Identifying, Assessing and Diagnosing Children With Cerebral Visual Impairment.

Abstract

Aim: Lack of global consensus regarding CVI makes assessment and research more difficult. Our aim is to describe current consensus and evident methods for how to identify, assess and diagnose CVI in children.

Method: Data-based search on reviews and papers published 2014-2023.

Result: The seven reviews and 23 papers reviewed here jointly convey a broad knowledge on CVI including its definition, assessment tools, and evidence-based methods to diagnose this condition. The definition of CVI as a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways, or any potentially co-occurring ocular impairment was confirmed. Assessment tools based on Dutton's CVI questionnaire were identified as being most relevant. A diagnosis of CVI should be assessed and established by a multidisciplinary team, following a cognitive assessment. A magnetic resonance imaging scan in addition to the ophthalmological examination can be valuable but is optional and is not on its own sufficient for diagnosis. The neuropsychological assessment must further include tests of visual and visuospatial perception. All assessments should be in co-operation with caregivers and teachers.

Conclusion: This scoping review demonstrates satisfactory evidence and consensus needed in order to proceed with general recommendations for assessment and diagnosis of CVI.