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Cerebral Palsy and Vision Problems

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Cerebral palsy vision problems occur in 75-90% of children with the condition. This is because vision problems and cerebral palsy are both usually caused by damage to the brain. It is very important to get your child’s vision tested. With proper diagnosis, many cerebral palsy vision problems can be effectively treated, significantly improving a child’s healthy development.

What Causes Vision Issues in Cerebral Palsy Patients?

Cerebral palsy vision problems are unfortunately very common. In fact, 1 in 10 children with cerebral palsy are blind and 75-90% have some degree of visual impairment.

Vision problems are often due to cortical visual impairment (CVI), which is caused by damage to the occipital lobe in the back of the brain. The occipital is responsible for receiving and interpreting incoming visual information.

When the occipital lobe receives information from the eyes’ retinas, it translates that information into motion, color, and orientation visual data to the brain.

The occipital lobe is linked with the following functions:

  • Determining depth, size, and distance
  • Identifying colors
  • Mapping out the visual world
  • Moving the eyes
  • Recognizing objects and faces

Damage to the occipital lobe is commonly caused by hypoxia, pressure in the head, and head trauma. Therefore, it is commonly associated with cerebral palsy, which is also usually caused by damage to the brain.

A study of 120 children with cerebral palsy performed by the National Institutes for Health (NIH) found:

  • 52.5% had a squint
  • 50% had significant refractive errors (inability to have clear focus)
  • 20% had normal eyesight
  • 15% had strabismic and anisometropic amblyopia (lazy eye)
  • 11% had visual field defects

Types of Vision Problems in Cerebral Palsy Patients

There are several different types of cerebral palsy vision problems. These CP vision problems can be interrelated with balance, posture, and coordination of visual perception.

Cerebral palsy vision problems include:

  • Cortical visual impairment (CVI) is one of the main causes of visual problems in children. It is caused by damage to the occipital lobe.
  • Lazy eye (amblyopia) happens when one eye is weaker than the other eye. Because the brain will naturally favor the stronger eye, the weaker eye usually continues to worsen.
  • Optic atrophy affects the optic nerve, interfering with the impulses from the eye to the brain. Damage to the optic nerve can cause vision problems such as blindness.
  • Nystagmus occurs when there are involuntary and repetitive movements of the eye.
  • Visual field defects create a blind spot in one or both eyes.
  • Refractive errors include farsightedness, nearsightedness, astigmatism, and blurry vision.
  • Squint (strabismus) is a condition that causes eyes to appear crossed. It is the most common CP vision problem, affecting 70.5% of patients.

An eye specialist can help identify and treat any type of cerebral palsy vision problem that your child may be experiencing.

Complications Associated With Vision Problems

The development of motor skills and the ability to move without significant effort is dependent on vision. Sight problems in cerebral palsy can discourage children from moving around, being curious, and having the motivation to explore their surroundings. This, in turn, can affect crawling and walking.

Additionally, cerebral palsy vision problems can interfere with the development of:

  • Cognitive function
  • Fine and gross motor skills
  • Language and communication
  • Play skills
  • Social skills
  • Self-help skills

For these reasons, it is very important to ensure your child is examined for vision problems.

Diagnosis & Treatment for Cerebral Palsy Vision Impairment

If your child is showing signs of visual impairment due to cerebral palsy, it is important to get a diagnosis from an ophthalmologist.

The doctor will usually look at three areas of possible concern:

  • Degree of sharpness in eyesight
  • Physical movement of the eyes when aiming at subjects
  • Processing of information that the brain receives

Treatment options for cerebral palsy vision problems will be individualized for the specific issues your child is facing.

Diagnosis and treatment will likely be a multidisciplinary approach, which may include:

  • Optometrical and audiometric testing
  • Psychological assessment
  • Physical rehabilitation
  • Vision therapy

Depending on the extent of the cerebral palsy vision problem, surgery may also be an option. Children with spastic cerebral palsy have a greater risk for certain types of CP vision problems and may need a more detailed ophthalmologic evaluation.

Studies have shown that correcting cerebral palsy vision problems has significant improvement in a child’s development. Therefore, it is essential to get a comprehensive evaluation to determine which options are best for your child.

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