University of Edinburgh

Prematurity and Vision

Friday 3 March 2006

Dr Lyn Cresswell, Consultant Paediatrician NHS Lothian

Cerebral Visual Impairment

  • Aetiology
  • Anatomy
  • CVI behaviour
  • Case Histories

Cerebral Visual Impairment-Aetiology

  • Preterm asphyxia - periventricular white matter damage PVL
  • Term asphyxia - occipital cortex damage
  • Neuronal Migration abnormalities
  • Trauma
  • CNS infection
  • Hydrocephalus with raised ICP


image processing

image store

motion & attention

executive planning unit

fast eye movement

ventral stream/dorsal stream


  • Fluctuant visual loss;
  • Impaired visual attention;
  • Lack of visual curiosity;
  • View objects at short range;
  • Pay closer attention to one toy than a range;
  • Use touch to explore;
  • Look away from an object whilst reaching for it;
  • Face is often expressionless;
  • Lack visual communication skills;
  • Smooth eye movements but may appear aimless;
  • Name colours more easily than shape;
  • Visual field defects, eg; tunnel vision;
  • Light Sensitivity;
  • Moving objects seen better than stationary ones.

JC dob 21/09/88

  • Spastic quadriparesis;
  • visual acuity 6/60 binocular;
  • myopia with astigmatism - glasses;
  • reduced visual field;
  • difficulties with visual processing.

What adaptations to environment or curriculum might you make?

KS dob 05/09/90

  • Cerebral visual impairment due to perinatal asphyxia
  • visual acuity 6/12 6/18;
  • absent lower visual field;
  • marked visual perceptual problems esp. visual memory & discrimination;
  • visuomotor problems esp. motor planning.

Tom Age 5

  • Twin born at 24 weeks
  • 6/12 R 6/60 L (myopia)
  • Trips over things
  • Walks into door frames and lamp posts
  • Cannot find toy in pile of toys
  • Can’t see distant objects
  • Uncontrolled in supermarkets.

brain scan

brain scan