Cerebral visual impairment and educational support in the United Kingdom: Understanding thresholds for providing support

Cerebral visual impairment (CVI) is the most common cause of visual impairment in children in the United Kingdom. The mainstay of management is providing strategies and environment adaptations to allow the child to use their vision for learning and independence. It is therefore important to understand educational access policies to facilitate timely and appropriate referral to qualified teachers for learners with visual impairment (QTVI) by ophthalmologists. QTVIs were recruited from VIEW (Visual Impairment England and Wales) and the Scottish Sensory Centre (QTVI organisations) via email, newsletter and social media. Respondents were directed to an online electronic questionnaire. 116 responses were received; this represents around 18% response rate. All services accepted referrals for children with cerebral visual impairment (CVI). The majority of services (97%) did not have a strict visual acuity threshold for children with CVI. There is an inconsistent approach in the diagnosis of CVI across the United Kingdom, with some QTVI expressing concern that this had prevented children with visual dysfunction from accessing help. QTVI indicated they would welcome more referrals for Cerebral VI, at an earlier age, and that a formalised referral pathway would be beneficial. Children with CVI are accepted for support by QTVI/sensory services regardless of visual acuity. Some services welcomed referrals for children undergoing assessment where CVI had yet to be confirmed. However, the formal diagnosis of CVI by an ophthalmologist as a pre-requisite to access services in other areas emphasises the need to improve clinicians’ confidence in the diagnosis of CVI. Ophthalmologists are encouraged to engage with local QTVI/sensory teams to facilitate exchange of information and appropriate and timely referral of children in need.