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Cerebral palsy is linked to a number of associated conditions, including vision problems. Not all children with cerebral palsy will experience vision problems. Still, all children should undergo regular screenings so that interventions can be put into place as early as possible for those who need them.
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.[1] 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, and, fortunately, the symptoms will not worsen over time. In fact, with treatment, the symptoms may even improve. Although there is no medical treatment for CVI currently, 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 turning of the eyes 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.[3]
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 any better vision than what they already see. 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, be sure to 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.
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- Cortical Visual Impairment | Symptoms & Causes. (n.d.). Boston Children's Hospital.
Retrieved from: https://www.childrenshospital.org/conditions/cortical-visual-impairment#symptoms-and-causes - What Is Strabismus? (2019, December 19). American Academy of Ophthalmology.
Retrieved from: https://www.aao.org/eye-health/diseases/what-is-strabismus - Hyperopia (Farsightedness). (n.d.). American Optometric Association.
Retrieved from: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/hyperopia