A Glasgow nurse is carrying out pioneering research into a little recognised condition which affects children’s eye-sight from birth.
Cerebral Visual Impairment (CVI) is a condition where there is a communication breakdown between a child’s vision and messages within the brain leaving the child unable to make sense of what they see.
In many cases there is little deterioration of the child’s sight, and as they grow older their visual difficulties may even improve.
And the study by Catriona Macintyre-Beon, NHS Greater Glasgow and Clyde’s Visual Impairment Specialist Nurse will produce simple and easy guidance for parents and schools to improve the quality of life for these children.
This involves supporting children and families with a new diagnosis of visual impairment and helping enhance development by promoting interaction.
Children with CVI can have difficulty navigating stairs, picking out a favourite toy from a toy box, and can’t enjoy cartoons or be aware of cars because the images move so fast that they can’t make out the details.
Catriona’s work will also create an assessment tool to pick up CVI earlier as a result of interviews with the parents of children already identified as having the impairment.
A general nurse and midwife with a special interest in neonatal intensive care, Catriona said: “There are many different causes of damage to the ‘vision’ parts of the brain.
“The damage can also occur at different times in the child’s life, but often it is not known what the cause of the damage to the brain is, nor is it well understood.
“Most often this damage happens while the child is still in the womb, with some cases possibly linked to the lining of the womb becoming infected which can be associated with premature birth.”
Visual problems can be picked up at assessments in the Royal Hospital for Sick Children at Yorkhill and other specialist clinics within the community , through a series of questions to parents.
Questions include does their child have difficulty going up stairs, is behaviour in a busy supermarket or shopping centre difficult, or do they have problems recognising close relatives in either real life or in photographs.
Catriona went on: “Children might be experiencing an inability to navigate steps without using hands and may be lifting their feet too high, early or late to negotiate the step effectively.
“Walking off the edge of kerbs is common, as is descending stairs without the help of a banister.
“If we can identify these children pre-school then the quality of life for them and their families can be improved by devising coping strategies.”
CVI can also cause apparent behavioural problems at school but a simple strategy of a “buddy system” can be introduced where a friend of the child is encouraged to look after them, particularly in the playground where they can feel isolated.
“Something as simple as a ‘buddy system’ can make school life so much better,” explained Catriona, “because many of these children develop behavioural problems as a result of feeling isolated when they can’t find a friend in the playground and often end up standing alone.
“This can lead to them being bullied at school and labelled as clumsy or a problem pupil.”
In school pupils with CVI may be helped by the introduction of tilted desks and the enlargement and optimal spacing of text, as well as reducing visual clutter within the area of the classroom where most of the teaching takes place.
At home youngsters may be helped by using neutral colours for walls, carpets and furniture, and by keeping pictures on walls to a minimum.
Catriona is now applying for a research project grant to continue her study which will involve conducting in-depth interviews with parents of children with confirmed diagnosis of CVI.
She added: “A diagnosis and introducing rehabilitational strategies combined with a change in attitude of parents and teachers makes a great difference to self-esteem and this will lead to affected children no longer being criticised but understood and helped.”
For more information visit Visual Impairment Scotland at www.viscotland.org.uk
Tel: 0131 651 6078.
For more information contact either NHS Greater Glasgow and Clyde Communications on 0141 201 4429 or email [email protected]