Peer-reviewed study confirms CVI range is a valid, reliable tool for assessing cortical visual impairment in children

Cerebral (or cortical) visual impairment (CVI) is a brain-based visual disorder that is the leading cause of pediatric visual impairment in developed countries. Unfortunately, because of low awareness, CVI is often misdiagnosed as other conditions—such as autism, ADHD or a learning disability.

This leads to costly, ineffective interventions and profoundly challenging effects on families struggling to find solutions for their child. Some estimates suggest that at least 3% of elementary schoolchildren globally exhibit CVI-related visual problems.

Christine Roman-Lantzy, founder and director of Pediatric VIEW at The Children’s Home of Pittsburgh, developed The CVI Range Assessment over decades of clinical work and research. Now, a new peer-reviewed study published in Ophthalmology Science has confirmed that The CVI Range Assessment is a valid and reliable instrument for evaluating functional vision in children with CVI. The study was led by Melinda Y. Chang at The Vision Center at Children’s Hospital Los Angeles, in collaboration with researchers from the University of Southern California and the University of Georgia. Co-authors include Roman-Lantzy and Francesca Crozier-Fitzgerald, M.Ed., CTVI, both practitioners at Pediatric VIEW at The Children’s Home of Pittsburgh.

The findings provide the first rigorous clinical validation of a tool that has been used by educators and vision specialists for decades, supplying the strongest evidence to date that The CVI Range Assessment meets clinical and psychometric standards. The study represents a meaningful shift in how CVI can be identified and addressed within the medical community.

“All too often, families anguish over a diagnosis of autism or attention disorder that they instinctively feel falls short of meeting their child’s needs. Unfortunately, many diagnosticians are unfamiliar with the signs of CVI and, as a result, may inadvertently misdiagnose a child with CVI as having a different condition,” explained Roman-Lantzy. “Incorrect diagnosis clearly results in the child receiving ineffective interventions, potentially throughout their school years.”

“Early detection of CVI is critical, and medical screenings continue to skip over a few key questions that could unlock the pathway to discovering CVI earlier in a child’s development. The challenge continues to be a lack of awareness about this disorder in the broader medical community.”

“The validation from this study gives clinicians worldwide a reliable way to identify and measure a child’s vision. This is critical to designing the most accurate supports that facilitate learning, social opportunities and self-determination,” continued Roman-Lantzy. “The CVI Range can also be used reliably to measure changes in functional vision over time. The clinical vetting of The CVI Range represents progress for an entire field—but more importantly, it brings hope for the millions of families and teachers who struggle with the complexities of getting a clear diagnosis of CVI for a child, so we can start to address it.”

What the study found

The prospective longitudinal study enrolled 40 children with CVI, assessing them at baseline and one year later using The CVI Range for Clinical Research (CVI Range-CR)—Roman-Lantzy’s assessment applied in clinical research settings.

The results were clear across every metric tested: internal consistency, intrarater reliability, correlation to clinical measures of visual behavior and sensitivity in detecting meaningful change over time. The authors concluded that The CVI Range-CR is a reliable and valid measure of functional vision in children with CVI—and that it is sensitive enough to detect real change, making it suitable for use in clinical trials.

Why this matters

CVI is the leading cause of childhood visual impairment in developed countries. Unlike ocular conditions, CVI involves dysfunction in the brain’s visual processing centers—meaning standard eye exams frequently miss or underestimate the impairment. The CVI Range measures how a child uses vision in daily life, guided by 10 distinct visual and behavioral characteristics, filling a critical diagnostic gap.

Until now, The CVI Range has been used primarily in educational settings, where it has guided individualized interventions for children at schools and in therapy. Its clinical validation changes the equation: It gives physicians, researchers and health systems a standardized, evidence-based tool for earlier and more accurate diagnosis and for measuring treatment outcomes in future trials.

“For nearly a decade, I have been referring patients to teachers for the visually impaired, who all use Roman-Lantzy’s CVI Range Assessment and practice modalities,” said Dr. Edward Kuwera, an ophthalmologist who was not affiliated with this study and is based at Johns Hopkins School of Medicine, where he specializes in pediatric conditions and adult strabismus. “These resources have had a tremendous impact on my understanding and ability to provide optimal care to my patients diagnosed with CVI and helped me differentiate their behavior from behaviors associated with autism—conditions requiring very different forms of therapy. The profound impact Roman-Lantzy has had on my patients’ outcomes and quality of life cannot be overstated, as her work is truly indispensable in pediatric ophthalmology.”

“Vision shapes all areas of development,” said Dr. Sarah W. Blackstone, CCC-SLP, a researcher not affiliated with this study and with extensive experience developing educational and communication strategies for children with CVI—including serving as a member of the Board of Directors for The Bridge School, which uses an internationally recognized model of inclusive education and communication access for children with speech and physical disabilities.

“Under Roman-Lantzy’s guidance, longitudinal research at The Bridge School in California showed that all students with CVI improved in their use of vision (measured by The CVI Range over multiple years). Improvement in vision strongly correlated with improvements across other developmental areas. In short, The CVI Range helps guide educational and clinical intervention practices, underscoring the need for and supporting the use of interprofessional, family-centered collaborative service delivery approaches.”

Provided by
The Children’s Home of Pittsburgh

Who’s behind this story?

Swati Mestri

Swati Mestri holds a bachelor’s degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space.

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Andrew Zinin

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