Visual Impairment in Infants and Young Children

Visual impairment in pediatric patients is caused by disorders within the eye or in the brain. No matter the cause, measurement of visual function and comparison to normal values for age contributes to the diagnosis and management of the child with visual impairment. A synopsis of normal development of visual functions is provided. The retina is the most common ocular site of vision-impairing disorders in children if one disregards refractive errors, cataracts, and structural abnormalities. The heritable retinal disorders, for which novel gene-based therapies are becoming a realistic possibility, and retinopathy of prematurity, for which understanding of the cellular and molecular biology has led to recent advances in care, are also discussed. A current perspective of pediatric cerebral visual impairment (CVI), the most common cause of permanent visual impairment in developed countries, is also presented. Across the breadth of these diverse disorders, optimal management depends on early accurate diagnosis that can be best accomplished using a multidisciplinary team.