CP can affect a person's body in different ways, and the same applies for their eyes. In a study published in 2012 in the journal “Developmental Medicine & Child Neurology”, researchers evaluated the prevalence of vision conditions in individuals with CP. The study found significant rates of the following vision conditions in individuals with CP:
Patients also had refractive errors (nearsightedness / farsightedness). The researchers also evaluated the magnitude of ocular involvement depending on the type of CP (the extent of motor impairment). They found the individuals with the most ocular involvement also had the most motor impairment. A general statistic that many find shocking is that 60-70% of individuals with CP have a manifestation of cortical visual impairment. Cortical visual impairment (CVI) is decreased vision in both eyes secondary to damage to the brain without any major ocular disease. Individuals with CVI commonly have difficulty with visual perceptual skills. Their vision may also fluctuate day to day so some days visual tasks are more demanding than others.
It is interesting to consider visual complications associated with CP because of the neurologic involvement. Many people may not know that the visual pathways extend into a large portion of the brain. Vision may start at the eyes in the front of the head, but it extends all the way to the area of the cortex associated with vision in the back of the brain. The visual pathways from each eye actually cross paths and meet in the back of the brain. So when a person has CP, which is damage or malfunction to a portion of the brain, the likelihood of the visual system being affected is higher. While the interference may be minimal it can still impact visual learning and daily life.
Individuals with CP are likely to have vision conditions associated with their condition. Fortunately treatment options are available for many of these conditions. Again, each CP patient is unique and treatment options should be tailored to the individual's needs. It is important for a child with CP to have a comprehensive eye examination with a residency-trained pediatric optometrist. An optometrist who has gone on to receive advanced, residency-training in pediatric eye care will have the knowledge and skill to evaluate the visual strengths and weaknesses of a patient with CP. Depending on the severity of the visual deficiencies, further investigation may be needed. A Binocular Vision Assessment (which would evaluate binocular skills and visual perceptual skills) or a Specialized Vision Assessment (which would assess functional vision and determine vision modifications that would be beneficial for learning and daily living) can be performed. Working with a residency-trained pediatric optometrist will provide a better understanding of your child's eye health, prescription and functional visual abilities.
To celebrate National Cerebral Palsy Month consider that each person with CP is an individual and they deserve to have individualized care and attention given to each aspect of their care - including eye care.