Compare Ocular to Cortical

I found this nice comparison chart for ocular vs cortical:

 

Characteristics                                           Ocular disorder                                     Cortical disorder

Eye examination                                         Usually abnormal                                        Normal

Visual function                                        Consistent                                         Highly variable

Visual attention span                                  Usually normal                                  Markedly short

Nystagmus                                          Present when congenital /early onset       Not present

Coordination:eye movements   Present when congenital/early onset                  Usually normal

Rapid horizontal head shaking                Occasionally                                                Never

Compulsive light gazing                                      Rarely                                              Common

Light sensitivity                            Dependent on the eye disorder                 A third of the cases

Eye pressing                                Especially in congenital retinal disorders                       Never

Close viewing                       Common, for magnification             Common: reduces complexity, crowding

Color perception                              Dependent on the eye disorder                        Preserved

Appearance                                        Appears to be vision impaired                    Usually normal

Peripheral field loss                                  Occasionally                                          Nearly always

Additional neurological handicaps       Fairly common                                        Nearly always

 

 

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8 comments

  1. My daughter has cvi but also nystagmus and horizontal head shaking. She also has optic nerve atrophy, which we’ve always been told is more cortical. But your chart makes it seem like she’s got at least some ocular impairment characteristics. Can you elaborate on this? Tia.

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    1. My understanding is that optic nerve atrophy is the ocular impairment. Anything further along the visual pathways and within the brain is cortical impairment. Some children with have an ocular impairment but their visual function is much poorer than the ocular condition can account for. In this case, CVI assessment within the 10 characteristics would let us understand how your daughter is using her visual brain. The good news is that cortical issues can improve with the right interventions. Where are you located?

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  2. My understanding is that optic nerve atrophy is the ocular impairment. Anything further along the visual pathways and within the brain is cortical impairment. Some children with have an ocular impairment but their visual function is much poorer than the ocular condition can account for. In this case, CVI assessment within the 10 characteristics would let us understand how your daughter is using her visual brain. The good news is that cortical issues can improve with the right interventions. Where are you located?

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    1. We’re in pittsburgh so we’ve been lucky to see dr. Roman. No ones ever been able to explain her head shaking before though, most of our therapists think it’s vestibular. If it IS related to her optic nerve atrophy, do you know of any interventions we could try?

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      1. I alway think that children do things that help them in some way otherwise why would they do it? It may just help her see better. Does she do it all the time or only when she is trying to look at something?

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    2. Actually, she stops shaking when she’s trying hard to look at something. She does it the most when there’s nothing to look at, or she’s having trouble seeing what we are asking her to look at. She also does it while walking, which is the most frustrating part.

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      1. Check out the longer answer on the recent blog post.
        If she stops head shaking when she’s trying to look at something, maybe the head shaking helped her locate it in the first place. When there is “nothing to look at”, do you mean things are near?
        It is so hard to answer your questions without seeing and knowing her. Its just important to remember that kids do not do things for no reason. This movement is providing her with something she needs.
        Thanks so much for your response. It gave me this post idea for all.

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