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Binocular Vision > Cerebral Visual Impairment - Lisa > Flashcards

Cerebral Visual Impairment - Lisa Flashcards

1
Q

What is does CVI stand for ?

A

Cerebral visual impairment (also known as cortical visual impairment)

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2
Q

What do we test in clinics?

A

primary visual systems

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3
Q

What is CVI?

A

Occipital lobe damage

(Technical definition is visual dysfunction that cannot be attributed to disorders of anterior visual pathways or co-occurring ocular impairment)

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4
Q

Name some possible aetiologies of CVI

A
  • hypoxic ishameic encephalopathy (HIE)
  • pentriventricular leucomalacia (PVL)
  • Traumatic brain injury
  • Congenital anomalies
  • Neurodevelopmental anomalies
  • Idiopathic
  • Meningitis
  • TIA
  • Shunted hydrocephalus
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5
Q

What is hypoxic ishameic encephalopathy (HIE)?

A

white matter damage Due to birth trauma

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6
Q

What is pentriventricular leucomalacia?(PVL)

A

white matter damage Due to prematurity

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7
Q

What is HIE and PVL both caused by?

A

Deprivation of blood and oxygen during birth

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8
Q

What an HIE and PVL lead to? (There are 6)

A
  • Cerebral palsy
  • Epilepsy
  • Developmental delay
  • Learning disabilities
  • Motor disorder
  • Speech disorders
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9
Q

Why is it difficult to predict symptoms and signs from an MRI scan of an child with CVI?

A

Due to neuroplasticity

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10
Q

What is neuroplasticity?

A

The brain creates new neural pathways and modifies existing ones in response to behavioral, environmental, and neural changes

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11
Q

Will an adult who has acquired CVI have more specific signs and symptoms?

A

YES

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12
Q

What is an example of an acquired way of getting CVI?

A

TIA

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13
Q

Have you watched Alfies’ video from the lecture?

A

No? Go watch it , it will help you understand what people with CVI can see/ cant see

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14
Q

What are 9 RF of CVI?

A
  • Cerebral palsy
  • Learning disability
  • Low blood sugar after brith
    -Premature birth
  • Traumatic birth
  • Epilepsy
    -Developmental delay
  • Motor disorders
  • Speech disorders
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15
Q

If a child is born before 34 weeks, what % are likely to have a visual processing disorder?

A

> 30%

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16
Q

What % of children with cerebral palsy will have a visual processing disorder?

A

50%

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17
Q

What are 7 co-existing ocular conditions with CVI?

A
  • Refractive error
  • Squint & amb
  • Nystagmus
  • Cataract
  • Glaucoma
  • retinitis pigmentosa
  • Keratoconous
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18
Q

Is it possible to recognise someones face when they are moving but not when they are static?

A

Yes- if there is damage to only the posterior occipital lobes only (green not red)

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19
Q

Which part of the brain stores our visual memories?

A

Temporal lobes (blue bit)

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20
Q

What part of the brain is responsible for motion planning and attention ?

A

Posterior parietal lobe (brown bit)

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21
Q

Which part of the brain is responsible for hand/eye coordination or if they are able to do direct visual guided movements?

A

Posterior parietal lobe (pink bit)

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22
Q

Which part of the brain is responsible for hand/eye coordination or if they are able to do direct visual guided movements?

A

Posterior parietal lobe (pink bit)

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23
Q

What is the bottom of the frontal lobes responsible for?

A

Executive planning for making choices

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24
Q

What does the motor cortex do?

A

Drives movement of the body and the frontal areas which drive fast movement of head and eyes

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25
Q

What is the ventral stream responsible for ?

A

Image storage and recognition system- conscious

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26
Q

What is the dorsal stream responsible for ?

A

Visual guidance, search and attentional system- unconscious

27
Q

Does ventral or dorsal stream damage occur more frequently?

A

Dorsal

28
Q

Should someone who is SSI have an eye test?

A

Of course! You need to check IOPs and everything to make sure it is still healthy (may show underlying issues)

29
Q

What is the main intervention for CVI?

A

Refractive error intervention - you still want to stimulate the back of the eye even though they may not necessarily understand it due to occipital lobe damage

30
Q

Can children with CVI be plano?

A

YES!

31
Q

As there may be oculomotor abnormalities, what else tests should you do?

A

Saccades and smooth pursuits
(as they are not processing properly, they have not learned to control their eye movements well)

32
Q

What may you see with a child with oculomotor abnormalities?

A

Nystagmus, inaccurate saccades, poor or absent pursuits

33
Q

What VF defect is common with CVI?

A

Homonymous hemianopia

34
Q

Can someone with CVI have colour vision issues and stereopsis issues?

A

Yes- their vision may be Plano but they may struggle with colour vision as they cannot communicate what they can see properly

35
Q

What would someone with dorsal stream damage struggle to do?

A

Give attention to components in a crowded scene and use vision to guide movement

36
Q

What would someone with ventral stream damage struggle to do?

A

Recognition of what is being looked at and recognition for route finding

37
Q

If you have done your eye test and everything is healthy but you still think there is a problem with vision, what should you do?

A

Ask questions such as :
- Does this child recognise faces without making sounds (no auditory clues)
- Are they able to find a high contrast target with their eyes and follow it
- Do they have difficulty judging depth and distance?
- Do they have difficulty navigating familiar faces?
- Can they spot someone is a crowded scene ?

38
Q

What test might help you detects whether a child is able to find a high contrast target with their eyes and follow it?

A

Bradford Visual Function box

39
Q

Will you able to assess a child’s visual function in one sight test?

A

No- it is dependent on child’s behaviour and may alter depending on tiredness + may involve parents or teaching staff to be observing a child

40
Q

Will you able to assess a child’s visual function in one sight test?

A

No- it is dependent on child’s behaviour and may alter depending on tiredness + may involve parents or teaching staff to be observing a child

41
Q

How do we screen for CVI?

A

Using Gordon Button’s 5 screening questions

42
Q

Using Gordon Button’s 5 screening questions, at what point would further investigation be required?

A

> 3 QStack are always/ often

43
Q

Just for you’re info this is what Gordon’s buttons CVI questionnaire looks like

A
44
Q

What are some day to day issues a child with CVI May face?

A
  • Cannot reach out to pick up something
  • Accessing information such as pictures or a letter box
  • Walking confidently
  • Recognising faces
  • Understanding facial expressions
  • Seeing a hand
45
Q

If a px had dorsal stream impaired search would they able to look and listen simultaneously?

A

Probably not (so do not say look at me when i am talking to you)

46
Q

What is simulanagnosia?

A

Only can describe objects without being able to perceive it
E.g they would not be able to say house , they would describe it as something we live in

47
Q

What is optic ataxia?

A

They cannot use visuospatial information for guided arm movements

48
Q

What is apraxia ?

A

Cannot produce accurate movements

49
Q

How can you as an optometrist help someone with CVI?

A

Correct refractive error

50
Q

What are the three B’s for visual impairment?

A

Bigger, bolder and brighter

51
Q

What can a parent do to help their child with CVI in relation to clutter?

A

Keeping their house tidy and free of clutter so they do not get over stimulated by too much crowding + keeping things in the same place

52
Q

Hemianopia is common with children with CVI, what advice could you give?

A
  • CHP
  • Supporters positioned standing to the side
  • Training in scanning info
  • Information displaced to the side

(Basc positioning everything to the sighted side)

53
Q

What advice could you give to someone with lower VF loss? (4 things)

A
  • Keep floors clear
  • If you are helping them walk, hold their arm slightly backwards for height changes
  • Chin in tilt
  • Raised near objects
54
Q

What are 7 dorsal stream dysfunction support strategies?

A
  • Good storage
  • Reduce clutter
  • Minimise decor
  • Not too much on a page + separation of words
  • Serif font
  • Limit distractions
  • Wait for 8
55
Q

What does wait for 8 mean?

A

Giving 8 seconds for them to process information

56
Q

What kind of background would help a someone with CVI?

A

Calm quiet surroundings

57
Q

What two things in particular would someone with ventral stream dysfunction struggles with?

A

Recognising objects and recognising faces

58
Q

Why is ventral stream dysfunction less common?

A

It is more protected

59
Q

What kind of saccades are 50% of Autistic people known to have?

A

Hypometric slow saccades

60
Q

What is cortical blindness?

A

loss of vision without any ophthalmological causes

61
Q

Can a person with cortical blindness move around a room with obstacles everywhere?

A

Yes because they are subconsciously aware but not consciously aware if them

62
Q

Have a look at seeability website if you want some more info

A

Gogogogoogogo if u what

63
Q

Why is TIA and HIE diffrent?

A

Neuroplasisity.

Binocular Vision (30 decks)

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