The Apparently Blind Infant

Brodsky, Michael C.

doi:10.1007/978-1-4939-3384-6_1

Cited by 5 publications

(11 citation statements)

References 686 publications

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“…The leading cause of CVI in children is hypoxic ischemic injury in the perinatal period. 1,2,[11][12][13] Other causes include traumatic brain injury, congenital central nervous system (CNS) malformation and infections, hydrocephalus, cerebrovascular accidents and metabolic disorders. 4,9,14 In Infants Acquired Causes (Late Childhood)…”

Section: Etiologymentioning

confidence: 99%

“…9 Obstetric risk factors for periventricular leukomalacia among preterm infants include intrauterine infection, premature rupture of membranes, maternal chorio-amnionitis, hemorrhage during the first trimester. 2…”

Section: Subcortical Visual Loss: Periventricular Leucomalacia (Pvl)mentioning

confidence: 99%

“…Their performance decreases in a cluttered environment. 2,3 Many of these children have a wide fluctuation in the visual function based on lighting conditions, tiredness, medications etc. Some of them prefer light-gazing whereas other parents complain of photophobia (less severe as opposed to retinal lesions).…”

Section: Clinical Featuresmentioning

confidence: 99%

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Cerebral Visual Impairment in Children

Ganesh¹

2018

DJO

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Cerebral visual impairment (CVI) is vision loss as a result of damage to the retrogeniculate pathway of the visual system in the absence of any ocular pathology and with the improvement of perinatal care and increased survival of the preterm babies, it accounts for the leading cause of visual impairment today. Perinatal hypoxic ischemic encephalopathy has been the most common cause of CVI. Morphology of lesion due to hypoxic ischemic injuries to the retrogeniculate visual pathways varies with the timing of the event and the mechanism. Injury during the first trimester results in congenital malformations. Liquefaction necrosis and tissue resorption without any gliotic changes are the major pathological changes. However, damage during the late second to third trimester causes periventricular leukomalacia from ischemic damage followed by gliosis of the subcortical areas. A careful assessment of functional vision as well as level of visual acuity is the first and foremost step in managing these children. Rehabilitation strategies form the backbone of complete management of children with CVI. Every child needs different and special services based on their functional visual and neurological deficit. A multidisciplinary approach is always the mainstay of treatment. Nevertheless, parental education and their cooperation optimises the management outcomes in children with cerebral visual impairment. Prompt diagnosis and timely intervention in terms of neurological, ophthalmological and rehabilitation services always has a rewarding result for children with CVI and their parents.

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Section: Etiologymentioning

confidence: 99%

Section: Subcortical Visual Loss: Periventricular Leucomalacia (Pvl)mentioning

confidence: 99%

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Cerebral Visual Impairment in Children

Ganesh¹

2018

DJO

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“…Severe hypoxic injury may lead to encephalomalacia with surrounding gliosis. [ 15 ] Other abnormalities seen include thinning of the corpus callosum, altered signals from the thalamus and putamen and cerebellar atrophy[ 10 15 ] [ Fig. 1 ].…”

Section: Structural Manifestationsmentioning

confidence: 99%

“…[ 4 ] Esotropia is more common in children with PVL and may be associated with latent nystagmus, dissociated vertical deviation and “A” pattern. [ 15 ] Other studies have shown that cortical visual loss is associated with exotropia more commonly than esotropia, whereas in those with subcortical visual loss (PVL), a significant predominance of esotropia over exotropia was seen. [ 6 ] Furthermore, children with more extensive neurological damage may have a congenital exotropia.…”

Section: Strabismus and Ocular Motor Deficitsmentioning

confidence: 99%

Neuro-ophthalmic manifestations of prematurity

Chhablani

Kekunnaya

2014

Indian J Ophthalmol

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Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.

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Managing the apparently blind child presenting in the first year of life: A review

Leahy,

Lo‐Cao,

Jamieson

et al. 2024

Clinical Exper Ophthalmology

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Severe vision impairment and blindness in childhood have a significant health burden on the child, family and society. This review article seeks to provide a structured framework for managing the apparently blind child presenting in the first year of life, starting from a comprehensive history and examination. Different investigation modalities and the increasingly important role of genetics will also be described, in addition to common causes of severe vision impairment. Crucially, a systematic approach to the blind infant is key to correct diagnoses and timely management. Incorrect diagnoses can be costly to all involved, however it is important to note that diagnoses can change with ongoing follow‐up and investigations. Furthermore, the modern age of ophthalmology requires a multi‐disciplinary approach and close collaboration with specialists including paediatricians, neurologists and geneticists, in addition to rehabilitation and low vision services, to ensure the best care for these vulnerable infants.

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The Apparently Blind Infant

Cited by 5 publications

References 686 publications

Cerebral Visual Impairment in Children

Cerebral Visual Impairment in Children

Neuro-ophthalmic manifestations of prematurity

Managing the apparently blind child presenting in the first year of life: A review

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