Cerebral Vision Impairment (CVI) is the leading cause of sight impairment in children in the UK. It occurs in adults alike, but is often overlooked as a cause for their visual difficulties. CVI can present in different ways, depending on the underlying visual processing dysfunctions. Common difficulties are: Only seeing one thing at a time, unable to control where to look, difficulties with reading and writing, finding going down stairs challenging, and feeling overwhelmed in cluttered or busy environments. Cirta Tooth supports patients, their families and carers to understand their visual impairments and gives advice about specific strategies for each individual.

 

This page contains information about CVI assessments with an introduction video, an outline of what happens in an assessment and 'Frequently Asked Questions'. If you want to dive deeper into some of the topics, please click here to explore publications on this topic by Cirta Tooth:

Cirta Tooth is an Associate member of CVI Scotland. This charity has developed a website with information for anyone wishing to understand more about CVI. Their website is well worth a visit!

www.cviscotland.org

CVI Appointments with Cirta Tooth

Face-to-Face

Cirta Tooth offers face-to-face CVI appointments at:

Cameron Optometry

5 St Vincent Street

Edinburgh EH3 6SW

www.cameronoptom.com

 

Online

Online assessments coming soon

 

Watch this space!

 

Register your interest

To make enquiries, book an appointment, or register your interest in online assessments, contact Cirta Tooth:

CVI Introduction Video

CVI Assessments

What happens in a CVI assessment?

In the CVI clinic, your visual difficulties are assessed and addressed. You will receive a short ‘triage questionnaire’ prior to booking your appointment in order to make sure that the CVI clinic is the appropriate clinic for assessing and addressing your visual needs and to help us tailor the assessment to your needs and circumstances. This questionnaire will be reviewed by Cirta Tooth. You will subsequently be asked to complete a tailored Question Inventory with more in-depth questions about your visual issues, in order to prepare for the assessment.

The assessment includes further history-taking, visual function tests, an Austin assessment (if applicable) and direct observation. After the appointment you will receive a comprehensive report, which you can share with anyone you wish.

 

Link to Austin Assessment:

https://www.austinassessment.org/

 

What is not included in a CVI assessment?

The CVI assessment does not replace a sight test. It is therefore recommended that you attend your regular optometrist for a sight test and address any issues before your CVI assessment if you have not already done so. 

 

CVI is a complex condition which is usually diagnosed by a team of healthcare professionals, including an ophthalmologist. It is not within the scope of the optometrist to diagnose CVI during a CVI assessment.

 

For a CVI assessment to be beneficial, a formal diagnosis is not required. Children with visual difficulties can be offered strategies specific to their situation and needs, regardless of the severity of these visual difficulties. It has been estimated that about one child in every classroom in mainstream education experiences one or more visual difficulties, related to visual processing. However, not every one of these children goes on to be diagnosed with CVI.

Frequently Asked Questions

What is cerebral vision impairment (CVI)?

Cerebral Visual Impairment (CVI) is an umbrella term for visual difficulties caused by the visual areas in the brain, rather than the eyes themselves. In children, CVI can affect their learning, social skills and friendship, and anxiety levels. It can affects adults in similar ways.

What causes CVI?

The underlying cause for visual processing difficulties is not always known for every patient.

CVI can be associated with premature birth, lack of oxygen in early development, cerebral palsy, Down’s Syndrome and neurodevelopmental conditions, such as autism, dyspraxia and dyslexia.

CVI can also develop later in life as a result of brain tumours, stroke, multiple sclerosis and dementia.

Any adults or children who experience visual difficulties related to brain-related conditions could benefit from a CVI assessment.

Why is CVI a 'hidden disability'?

Adults and children with CVI have difficulties processing the visual world around them. As a result, they perceive the world differently to those without CVI.

Most people with CVI find it hard to describe or understand their visual difficulties, because these difficulties are unconscious brain processes.

In a CVI assessment the visual difficulties are identified and explained, and suitable interventions are explored to overcome these difficulties.

How can I recognise CVI in a child?

The diagnosis of CVI is usually a team effort of a number of health care professionals. 

In each child, the visual difficulties present in different ways, depending on many factors, including the underlying nature of the visual impairment.

Teachers or parents of children may have noticed that a child appears to have difficulties with concentration and focus, or that they often startle, struggle with social interactions or get upset in busy environments.

Visual difficulties can be assessed and addressed without a formal diagnosis of CVI.

How can I recognise CVI in an adult?

In adults, CVI can be a longstanding condition since childhood, in which case the underlying cause is not always clear.

In some cases CVI develops after brain injuries, tumours, stroke or haemorrhages, or it can develop in conditions, such as multiple sclerosis, Alzheimer's disease or cortical atrophy.

The visual difficulties manifest in different ways, but we often see that people with CVI easily loose things, feel more tired, struggle with independence and cannot read for long periods of time.

The visual difficulties can be assessed and addressed without a formal diagnosis of CVI.

What are common visual difficulties in CVI?

Common difficulties we come across in our practice are:
- Only seeing one thing at a time
- Unable to control where to look
- Difficulties with reading and writing
- Finding going down stairs more challenging than going up
- Feeling overwhelmed in cluttered or busy environments

How can people with CVI be supported?

We understand that no two people with CVI are the same.
Our assessments are tailored to the individual using a range of approaches, and our support is personalised — targeted to what each person needs in their daily life, not just generic advice.

Resources

CVI Scotland

CVI Scotland is a web-based charity, developing knowledge and understanding about CVI and providing  information for affected people and their families. The website contains a series of bite-size lessons about CVI, blogs from affected people and from professionals, a reading tool, videos about CVI, and much more!

www.cviscotland.org

The CVI Society

This society is a registered charity in England and Wales, which provides support to affected people and their families.

https://cvisociety.org.uk/

Scottish Sensory Centre

This website is primarily for (educational) professionals who support children with CVI

Scottish Sensory Centre Resources: Guides to CVI Assessment

Koninklijke Visio (Royal Dutch Visio)

This is an expertise centre for people with vision impairment, based in The Netherlands.

https://www.visio.org/home/

Visio produced a 10 min video about CVI, explaining the condition using case examples:

What is CVI? The story of Christy, Floris and Bertine (English version)