Cortical Visual Impairment
CVI Treatment India
CVI is the leading cause of childhood visual impairment in India - yet it is consistently missed because the eyes appear healthy on standard examination. Our FCOVD/FOVDR-certified neuro-optometric specialists provide phase-based CVI rehabilitation in Chennai and via telehealth.
What Is Cortical Visual Impairment (CVI)?
Cortical Visual Impairment (CVI) - also called cerebral visual impairment - is a neurological condition in which the brain's visual cortex cannot correctly interpret images sent by structurally healthy eyes. Unlike short-sightedness or amblyopia, CVI is a brain-processing problem, not an eye problem.
Because the eyes look normal and a standard eye test returns normal results, CVI is regularly missed for years. Correct diagnosis requires a specialist neuro-visual evaluation using the CVI Range assessment framework developed by Dr Christine Roman-Lantzy.
Why CVI Is Frequently Missed
- Standard eye exams return normal results in CVI
- The eyes are structurally healthy on examination
- CVI behaviours are often attributed to autism, ADHD, or sensory processing disorder
- A specialist CVI Range assessment is required for accurate diagnosis
Common Causes of CVI in Children in India
01 - Prematurity
Periventricular Leukomalacia (PVL)
Damage to white matter around the brain's ventricles, most common in premature infants. PVL directly affects the visual radiations and is one of the most frequent causes of CVI in India.
02 - Birth Injury
Hypoxic-Ischemic Encephalopathy (HIE)
Oxygen deprivation to the brain at or around birth. The occipital lobes and visual cortex are particularly vulnerable. CVI assessment is recommended for all children with confirmed HIE.
03 - Associated Condition
Cerebral Palsy
40-75% of children with cerebral palsy have some degree of CVI. Vision problems are frequently underdiagnosed because the child's motor challenges take priority in clinical assessment.
04 - Premature Birth
Very Preterm Infants
Infants born before 32 weeks are at significant risk of CVI due to the immaturity of the visual cortex. CVI often coexists with ROP - which is screened for - while the CVI component goes unassessed.
Characteristics of CVI
Key pattern: These behaviours are not defiance, autism, or inattention. They are the direct result of how the CVI brain processes visual information.
- Preference for a single colour (often red or yellow)
- Difficulty seeing objects against a busy visual background
- Better vision for familiar than unfamiliar objects
- Visual latency - delayed response to visual stimuli
- Need for movement to attract and hold visual attention
- Avoidance of direct eye contact, preferring peripheral gaze
- Difficulty reaching accurately for objects seen
- Better visual function in low-complexity, dimly lit environments
Phase-Based CVI Rehabilitation - How It Works
The Roman-Lantzy phase-based framework ensures intervention is precisely matched to where the child is in their visual development.
Case History and Medical Review
A detailed review of birth history, NICU stay, neuroimaging findings, and existing neurodevelopmental reports. We establish the nature and extent of brain injury and the child's full visual history.
CVI Range Behavioural Assessment
The CVI Range evaluates the presence and severity of each of the 10 CVI characteristics through structured observation. The resulting score places the child in one of three intervention phases and guides programme design.
Functional Vision Assessment
We assess how the child uses vision in real-world tasks - reaching, tracking, recognising faces, navigating environments. This determines which visual skills are most important to target in rehabilitation.
Phase-Matched Rehabilitation Programme
The programme is designed to match the child's CVI phase. Phase I focuses on single, high-contrast objects in low-complexity environments. Phases II and III progressively build complexity tolerance, array recognition, and visual curiosity.
CVI FAQs
Can CVI improve with therapy?
Yes. Phase-based CVI rehabilitation consistently produces measurable improvements in visual attention, complexity tolerance, and functional skills. Early intervention produces the most significant gains, but meaningful improvement is possible even when therapy begins later in childhood.
My child's eye exam was normal - can they still have CVI?
Yes - and this is precisely why CVI is so commonly missed. Standard eye exams assess the eye itself; they do not assess how the brain processes what the eyes see. A child with CVI will typically pass a standard eye test. A specialist CVI Range assessment is required for an accurate diagnosis.
At what age should CVI assessment begin?
As early as possible. For children with known risk factors - premature birth, HIE, PVL, or cerebral palsy - a CVI assessment should be arranged as soon as the child is medically stable, ideally within the first year of life. Earlier identification makes best use of the brain's neuroplasticity window.
Can CVI coexist with autism or developmental delay?
Yes. CVI frequently coexists with autism spectrum disorder, cerebral palsy, and developmental delay because these conditions share the same neurological origins. An accurate CVI diagnosis matters even alongside other diagnoses because it changes how therapy and the environment should be structured.
Concerned your child may have CVI?
Book a specialist CVI Range assessment in Chennai or request a telehealth consultation anywhere in India.