Cerebral Palsy and Vision Impairment

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Cerebral palsy is linked to several associated conditions, including vision problems. Many children with cerebral palsy experience vision problems. All children should undergo regular screenings so that interventions can be implemented as early as possible for those who need them.

How Common Are Vision Problems in Cerebral Palsy?

Children with cerebral palsy have higher rates of vision impairment than children without it. In one study, 76% of children with cerebral palsy had some kind of vision problem or eye condition.[1]

Another study looked at 419 children with cerebral palsy. Of those children, 266 had vision impairment to some degree. Eleven percent of the children had severe visual impairment.[2]

Types of Vision Impairment Associated with Cerebral Palsy

Causes of visual impairment in children with cerebral palsy are categorized as issues related to the eye and those related to the brain.

Cerebral Visual Impairment

Cerebral visual impairment (CVI) is a visual disability caused by brain damage.[3] The severity of the impairment depends on what part of the brain is damaged and how serious the damage is.

Symptoms of CVI include:

• Difficulty focusing on objects
• Blurred vision
• Field vision loss
• Problems with fast eye movements
• Trouble recognizing familiar faces

Not all children will exhibit every symptom of this type of impairment; fortunately, the symptoms will not worsen over time. In fact, with treatment, the symptoms may even improve. Although there is currently no medical treatment for CVI, children often benefit by using corrective prescription glasses, contact lenses, or other visual aids.

Eye Visual Impairment

Some children with cerebral palsy will experience vision issues due to problems with their eyes directly, as opposed to the brain. The most common type of vision problems associated with eye impairment include:

Strabismus

Strabismus is a medical condition marked by the eyes turning in different directions.[2] For example, one eye turns upwards while the other eye looks downwards, or one eye turns inward while the other eye moves outwards. This condition can lead to blurred vision and amblyopia, also known as “lazy eye,” which can cause the brain to ignore signals from the less dominant eye.

Eye exercises and prescription glasses are typical treatment options for strabismus. In some instances, the child may need to wear a patch over the stronger eye, which helps to improve vision in the “lazy” eye. For children who need additional medical assistance after these options have been exhausted, physicians may recommend surgery to help control eye movement.

Hyperopia

Hyperopia, also known as far-sightedness, is another visual impairment caused by eye abnormalities and can affect children with cerebral palsy. Symptoms include the ability to see clearly from far away, but when objects are up close, they become blurry and out of focus.[5]

Prescription glasses or contact lenses typically help correct these visual deficits, but surgery is also possible if corrective vision devices fail to work.

Signs Your Child May Have Vision Problems

Children usually don’t realize they may have eyesight issues because they have never experienced better vision than they already have. It is up to parents and caregivers to look for signs and symptoms that there might be a problem.

Some of the most common signs that your child may have vision problems include:

• Covering one eye while trying to read
• Moving the head while reading (as opposed to moving the eyes)
• Underdeveloped hand/eye coordination
• Squinting when reading or attempting to focus on objects
• Holding books or other materials close to the eyes or too far away when reading
• Frequent headaches and a feeling of eye strain

Getting a Diagnosis For Your Child

If you feel your child may have vision problems, schedule an appointment with a pediatric ophthalmologist as soon as possible, preferably one who has experience with children with cerebral palsy. If you need assistance finding an ophthalmologist or need a referral, speak with your child’s pediatrician.

A typical eye and vision examination consist of:

• Evaluation of eye movements
• Testing eye pressure
• Vision assessment
• Checking for color-blindness
• Dilation test

An ophthalmologist will also look for any eye abnormalities, infections, or cataracts and how well the child’s eyes react to stimuli.