A study from Mass General Brigham for Children introduces a multidisciplinary approach to identify cerebral visual impairment early in high-risk infants, potentially transforming paediatric neuro-visual diagnostics.
A new study from Mass General Brigham for Children is seeking to close a long-recognised gap in neonatal care by improving the early detection of cerebral visual impairment, a brain-based condition that can leave children struggling to process what they see even when their eyes appear healthy. The work, led by Mohamed El-Dib, focuses on babies in neonatal intensive care units, where known neurological risk factors may already be present before discharge. Researchers say that matters because the developing brain may be more responsive to support in the earliest months of life.
Cerebral visual impairment, often shortened to CVI, is caused by damage or differences in the brain’s visual pathways rather than by disease in the eye itself. According to HealthyChildren.org, it is among the most common causes of vision loss in children in the United States, and early diagnosis can improve access to support that helps learning and development. Yet the condition is frequently missed in infancy because its effects may not become obvious until a child is older and faced with more complex visual tasks. Recent summaries indexed by the National Center for Biotechnology Information and published reviews in 2026 point to a wider effort to improve screening, assessment and referral, reflecting concern that CVI is still underrecognised in routine paediatric care.
The Mass General Brigham team surveyed 62 clinicians at Brigham and Women’s Hospital’s level III NICU and found that while many were familiar with CVI and its major risk factors, their practices varied widely. Most respondents said they did not routinely discuss CVI risk with families, and many said they lacked confidence in explaining the condition or in deciding next steps when risk was suspected. The researchers say that inconsistency is especially important because infants at higher risk often include those born prematurely or those with brain injuries such as intraventricular haemorrhage, hypoxic-ischaemic encephalopathy, seizures, stroke, central nervous system infection or certain genetic and metabolic disorders.
In response, the team developed a multidisciplinary clinical practice guideline aimed at giving NICU staff a clearer pathway for identification, communication and referral. The guidance calls for high-risk infants to have a comprehensive ophthalmological assessment within the first six months of life and encourages referral to developmental services and vision-specific supports. The project also introduced educational materials, structured talking points, electronic prompts and a tracking system to help prevent follow-up from being lost after discharge. In the first five months, the team identified 45 eligible infants and successfully arranged follow-up for 39 after accounting for transfers, relocations, infants already in care and deaths during hospitalisation.
The early results suggest the approach may make CVI easier to recognise in the hospital setting, where many of the children at risk are already being treated for other serious conditions. The researchers caution that longer-term study is still needed to show whether the guideline improves diagnosis rates, referral completion and developmental outcomes. Even so, the work adds to growing evidence that earlier recognition of CVI could give children access to support during a critical period of brain development, when intervention may have the greatest chance of helping.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
