New England College of Optometry, Boston MA; NECO Clinical Network @ Perkins, Watertown, MA.
Private practice, Salina, KS.
Semin Pediatr Neurol. 2019 Oct;31:25-29. doi: 10.1016/j.spen.2019.05.005. Epub 2019 May 11.
Cerebral/cortical visual impairment (CVI) is characterized by higher order visual dysfunction caused by injury to the retrogeniculate visual pathways and brain structures which subserve visual processing. CVI has become the leading cause of significant vision loss in children in developed countries, but continues to be an under-recognized cause of visual disability with respect to services aimed at maximizing visual development. Current criteria which are used to define visual disability rely on measures of visual acuity and visual field. Many children who require specialized vision services do not qualify, because these standard definitions of vision impairment do not account for CVI. In order to appropriately identify patients with CVI and offer the resources which may positively impact functional use of vision, the definition of visual impairment and blindness needs to be modified. This commentary calls for a change in the definition of visual impairment and blindness to acknowledge those persons with brain-based vision impairment.
脑/皮质性视觉障碍（CVI）的特征是由视放射和视觉处理的脑区损伤引起的高级视觉功能障碍。CVI 已成为发达国家儿童视力严重丧失的主要原因，但在旨在最大限度促进视觉发育的服务方面，CVI 仍然是视觉障碍的一个未被充分认识的原因。目前用于定义视觉障碍的标准依赖于视力和视野的测量。许多需要专门视力服务的儿童不符合条件，因为这些视力损害的标准定义没有考虑到 CVI。为了正确识别 CVI 患者并提供可能对视觉功能使用产生积极影响的资源，需要修改视觉障碍和失明的定义。本评论呼吁修改视觉障碍和失明的定义，以承认那些有基于大脑的视觉障碍的人。
