A New Hope In Cerebral Vision Impairment: A Case Report

Abstract

Cerebral vision impairment (CVI) is a common cause of vision problem in young child. Standard protocol of vision testing often failed to provide optimum assessment and management thus leave patient to conservative management. In this report, the effectiveness of CVI rehabilitation is discussed. We present the case report of a 13 years old Malay boy with CVI as a result of traumatic brain injury. CVI assessment was done using CVI direct assessment form and CVI rating form. Those forms were based on 10 CVI characteristic.On first visit, patient showed six CVI characteristics which are long latency, present of visual field preference, difficulty in distance viewing, difficulty with visual complexity and non-purposely gaze. The remaining four characteristics which are colour preference, need for movement, atypical visual reflexes and absence of visually guided reach were resolved. During that time, standard vision testing protocol was not possible.Patient was monitored for 22 months with the interval visits were 4-6 months. Latest visit showed remarkable changes as more CVI characteristic had resolved which are visual latency, visual field preference and difficulty with visual complexity. However, characteristic of difficulty in distance viewing and non-purposely gaze still present. Further assessment showed patient able to discriminate between same and different toys and standard vision testing protocol can be tested in this patient. CVI rehabilitation is useful to improve visual behaviour in patient with CVI. With systematic intervention, the functional vision may show steady progression. Therefore, the impact of vision impairment in young child can be minimised.