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Cerebral visual impairment‐related vision problems in primary school children: a cross‐sectional survey
Author(s) -
Williams Cathy,
Pease Anna,
Warnes Penny,
Harrison Sean,
Pilon Florine,
Hyvarinen Lea,
West Stephanie,
Self Jay,
Ferris John
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14819
Subject(s) - visual impairment , medicine , visual acuity , cross sectional study , psychology , low vision , pediatrics , optometry , psychiatry , ophthalmology , pathology
Aim To estimate how many children in mainstream primary schools have cerebral visual impairment (CVI)‐related vision problems and to investigate whether some indicators might be useful as red flags, if they were associated with increased risk for these problems. Method We conducted a survey of primary school children aged 5 to 11 years, using whether they were getting extra educational help and/or teacher‐ and parent‐reported behaviour questionnaires to identify children at risk for CVI. These and a random 5% sample were assessed for CVI‐related vision problems. We compared the usefulness of potential red flags using likelihood ratios. Results We received questionnaires on 2298 mainstream‐educated children and examined 248 children (152 [61%] males, 96 females [39%]; mean age 8y 1mo, SD 20mo, range 5y 6mo–11y 8mo). We identified 78 out of 248 children (31.5% of those examined, 3.4% of the total sample), who had at least one CVI‐related vision problem. The majority (88%) were identified by one or more red flag but none were strongly predictive. Fewer than one in five children with any CVI‐related vision problem had reduced visual acuity. Interpretation Children with CVI‐related vision problems were more prevalent than has been appreciated. Assessment of at‐risk children may be useful so that opportunities to improve outcomes for children with CVI‐related vision problems are not missed. What this paper adds A minimum of three percent of primary school children had at least one cerebral visual impairment (CVI)‐related vision problem. Fifteen percent of children with at least one CVI‐related vision problem had reduced visual acuity. Seventy‐nine percent of children with CVI‐related vision problems were already receiving extra educational help. Impact scores (indicating possible behavioural or developmental difficulties) from parents were more predictive than those from teachers. Testing eye movements and fields with distraction increased the numbers of children classed as having impairments.