Cerebral visual impairment‐related vision problems in primary school children: a cross‐sectional survey

CVI Prevalence Study Group

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Abstract

Aim

To estimate how many children in mainstream primary schools have cerebral visual impairment (CVI)‐related vision problems and to investigate whether some indicators might be useful as red flags, if they were associated with increased risk for these problems.

Method

We conducted a survey of primary school children aged 5 to 11 years, using whether they were getting extra educational help and/or teacher‐ and parent‐reported behaviour questionnaires to identify children at risk for CVI. These and a random 5% sample were assessed for CVI‐related vision problems. We compared the usefulness of potential red flags using likelihood ratios.

Results

We received questionnaires on 2298 mainstream‐educated children and examined 248 children (152 [61%] males, 96 females [39%]; mean age 8y 1mo, SD 20mo, range 5y 6mo–11y 8mo). We identified 78 out of 248 children (31.5% of those examined, 3.4% of the total sample), who had at least one CVI‐related vision problem. The majority (88%) were identified by one or more red flag but none were strongly predictive. Fewer than one in five children with any CVI‐related vision problem had reduced visual acuity.

Interpretation

Children with CVI‐related vision problems were more prevalent than has been appreciated. Assessment of at‐risk children may be useful so that opportunities to improve outcomes for children with CVI‐related vision problems are not missed.

Original languageEnglish
Pages (from-to)683-689
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Volume63
Issue number6
Early online date3 Feb 2021
DOIs
Publication statusPublished - Jun 2021

Bibliographical note

Funding Information:
Members of the CVI Prevalence study group are as follows: Trudy Goodenough, Rose Watanabe, Rosie Clark (Bristol Medical School, University of Bristol, Bristol), Megan Evans (University Hospital Southampton NHS Trust, Southampton), Dan Osborne (Clinical and Experimental Sciences, University of Southampton, Southampton), Estelle Edwards, Cathy Billington, Rebecca Hunn (Gloucestershire Hospitals NHS Foundation Trust, Gloucester), and Gurdeep Matharu (University Hospitals Bristol NHS Foundation Trust, Bristol). We thank the children, families, teaching, and administrative staff in all the schools who took part and the orthoptists who either did the testing or covered extra clinics to allow their colleagues to do so. The participating schools are listed in Appendix S2 (online supporting information). We thank the Good‐Lite Company for their generous donation of additional test materials. This study presents independent research funded by the National Institute for Health Research Senior Fellowship award SRF_08_005. The views expressed are those of the authors and not necessarily those of the NHS, National Institute for Health Research, or the Department of Health and Social Care. The authors have stated they had no interests that might be perceived as posing a conflict or bias.

Funding Information:
Members of the CVI Prevalence study group are as follows: Trudy Goodenough, Rose Watanabe, Rosie Clark (Bristol Medical School, University of Bristol, Bristol), Megan Evans (University Hospital Southampton NHS Trust, Southampton), Dan Osborne (Clinical and Experimental Sciences, University of Southampton, Southampton), Estelle Edwards, Cathy Billington, Rebecca Hunn (Gloucestershire Hospitals NHS Foundation Trust, Gloucester), and Gurdeep Matharu (University Hospitals Bristol NHS Foundation Trust, Bristol). We thank the children, families, teaching, and administrative staff in all the schools who took part and the orthoptists who either did the testing or covered extra clinics to allow their colleagues to do so. The participating schools are listed in Appendix S2 (online supporting information). We thank the Good-Lite Company for their generous donation of additional test materials. This study presents independent research funded by the National Institute for Health Research Senior Fellowship award SRF_08_005. The views expressed are those of the authors and not necessarily those of the NHS, National Institute for Health Research, or the Department of Health and Social Care. The authors have stated they had no interests that might be perceived as posing a conflict or bias.

Publisher Copyright:
© 2021 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

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