Impairment of vision in children due to damage to the brain: a practical approach

Abstract

Aim : To describe the visual problems which children with brain damage may experience and to describe approaches to these, applicable to everyday life. Methods : A literature-based essay is presented using relevant articles and practical experience. Results : Damage to the brain can affect both visual input and visual processing. Degradation of visual input results in reduced visual acuity, reduced contrast sensitivity and restricted visual fields. The dorsal stream passes between the occipital cortex and the posterior parietal lobes, which serve the ability to extract visual data from a complex scene, visual attention and the visual guidance of movement. The ventral stream passes between the occipital lobes and the temporal lobes and is responsible for recognition of what is being looked at and orientation. Any of these visual functions can be impaired to any degree and in any combination. Structured history-taking and clinical examination is required to fully char­acterise the visual problems in each affected child in order to devise a tailored management strategy matched to the child’s needs. Conclusion : Structured history-taking and clinical examination in children with visual impairment secondary to brain damage can allow management to be customised to the individual requirements of that child.