Cerebral Palsy & Vision

Vision problems are unfortunately prevalent with cerebral palsy. It is estimated that 1 in 10 children with cerebral palsy are blind, and 75–90% have some degree of visual impairment. That makes vision worth looking at carefully and early — not as an afterthought once everything else is underway.

Because cerebral palsy involves the brain, the difficulty is often in how the eyes move and how the brain interprets what they see, rather than in how clearly the eyes see. Three patterns come up most often.

Field Loss

A person's visual field is what they can see when they look ahead. A full visual field extends 180 degrees horizontally. Different types of field loss include hemianopia (loss to the right or left, or the upper or lower field), central loss (a spot in the center of one's field of view), and peripheral loss (sight loss at the edges of the vision field).

Field loss changes how a person moves through a room, finds the next word on a page, or notices someone approaching from one side — and it is easy to mistake for inattention. Once it is identified, low-vision strategies and simple environmental changes can make everyday tasks considerably easier.

Ocular Motor Dysfunction

Ocular motor dysfunctions are conditions that affect the movement of the eye, as well as depth perception. When the eyes cannot fixate steadily, follow a moving target, or jump accurately from one point to the next, reading, catching a ball, and judging distance all take far more effort than they should.

Cortical Visual Impairment

CVI occurs when the eye cannot make sense of what a child sees. This condition exists in the brain, not in the eyes: children can see, but can't interpret images. The severity of the visual impairment depends on what part of the brain is damaged and how serious the damage is.

We evaluate carefully and adapt to each patient's motor, speech, and communication needs — including objective testing when a spoken answer is not possible — and we coordinate with the broader care team, from physical and occupational therapists to teachers and physicians. Findings come back in plain language everyone on that team can use.

Where visual skills can be built, vision therapy and neuro-optometric rehabilitation work on them directly; where they cannot, lenses, prism, and low-vision strategies focus on making the vision that is there as usable as possible. See special-needs eye care for how we adapt an exam, or run the symptom checklist if you are not sure what you are seeing. Not sure vision is the issue at all? Start with signs of a vision problem.

Care starts with a comprehensive developmental and binocular vision evaluation that pinpoints exactly what's happening. From there, Dr. Murray builds an individualized plan — which may include lenses or prism, in-office vision therapy, and coordination with your other providers — at our Boynton Beach and Boca Raton offices.