Visual Impairment in Cerebral Palsy

Cerebral palsy is a disorder of movement and posture due to damage to immature brain which can be either cortical, subcortical, or both. Early brain malformations and congenital or postnatal infections affect not only the motor areas of the brain but also many levels of the visual pathway leading to various visual disorders and to a misinterpretation of the visual world. Ocular and visual abnormalities are very frequent in cerebral palsy (50–90%). The severity of visual impairment is related to the area and to the extent of the brain damage. Most children experience difficulties with their visual acuity; visual fields; contrast sensitivity; binocular vision; ocular alignment; ocular motility (uncoordinated saccades and pursuits, paroxysmal ocular deviations, fixation instability, dyskinetic eye movement disorder, ocular motor apraxia); visual-guided movements; visual searching; recognition of faces, objects, and/or routes, visual attention, and in maintaining eye contact. Visual impairment plays a key role in psychokinetic development of these children. An early ocular, visual, oculomotor, and visuoperceptual assessment is very important. The accurate detection of visual disorders not only leads to a complete clinical diagnosis but also to an appropriate intervention plan.