From what I understand, MRI findings help support the diagnosis of CVI, but they cannot provide definitive evidence. A developmental ophthalmologist or pediatric neuro-ophthalmologist has to make the diagnosis based on visual behaviors they see during evaluations. I think I might be on high alert to make a referral if a kiddo of mine has a history of prematurity, HIE, PVL, CP, or some other neurologic condition and was demonstrating inconsistent visual attention, having difficulty with visual complexity, or showing a preference for movement or light. I think if you’re seeing visual behaviors that are not lining up with regular vision exam findings and are starting to interfere with participation and their mobility, referral to a specialized ophthalmologist would be reasonable.
