Testing Visual Function and Visual Evaluation Outcomes in the Child with Cerebral Palsy

Abstract

Vision is an important area to evaluate in children with cerebral palsy, playing a key role in learning and development throughout a child’s lifetime. Understanding the role of vision in the daily lives of children with cerebral palsy (CP) and having knowledge of the high prevalence of ocular and vision disorders associated with CP are essential in the medical, rehabilitation, and education profile for each child. Vision disorders affecting a child’s performance of vision-dependent tasks are often overlooked, undiagnosed, or unrecognized. Evaluating the visual function of children with cerebral palsy (CP) can, however, present challenges for eye care practitioners as children with CP may not be responsive to standard testing procedures for a wide range of reasons. As a result, erroneous labels such as severe visual impairment, “untestable,” or “blind” have been applied, despite reports by parents, teachers, therapists, and caregivers that these children appear to show visual responses. This chapter discusses the common ocular and vision disorders in children with CP and the components of a clinical vision evaluation for children with CP who may have widely disparate levels of communication, cognitive, and motor skills. This is followed by management of vision disorders and implications of assessment outcomes on overall function for the child with CP. The eye care provider can contribute important information regarding how a child sees, the potential for improvements in vision, and recommendations to allow educators and rehabilitation specialists to integrate vision into the child’s comprehensive education and rehabilitation programs.