Can Cerebral Palsy Affect Your Child’s Vision?

If your child has been diagnosed with cerebral palsy, you’ve probably already learned that CP affects far more than just movement. While most people associate cerebral palsy primarily with physical challenges, the same brain injury that causes motor difficulties can also affect how your child sees and processes visual information.

The short answer is yes: cerebral palsy can significantly affect vision. In fact, vision problems are one of the most common conditions that occur alongside CP. Understanding this connection, what to watch for, and how vision issues can be addressed is an essential part of supporting your child’s development and quality of life.

How Common Are Vision Problems in Children with Cerebral Palsy?

Vision impairment isn’t a rare complication of cerebral palsy. It’s actually something that affects the majority of children with CP to some degree.

Research tracked by the CDC and multiple epidemiological studies shows that 40 to 70% of children with cerebral palsy have some form of visual impairment. Some comprehensive studies have found measurable vision problems or eye conditions in up to 76% of children with CP.

Not all vision problems are severe. Many children have mild issues that can be corrected with glasses or managed with therapy. However, severe vision impairment, including legal blindness or profound vision loss, affects approximately 10 to 15% of children with CP. The likelihood of severe impairment increases in children who have quadriplegic or bilateral spastic forms of cerebral palsy, as well as those who were born extremely premature.

These aren’t small numbers. If your child has CP, there’s a significant chance they may also experience some level of vision difficulty, which is why vision screening should be a routine part of their care from early on.

Why Does Cerebral Palsy Cause Vision Problems?

To understand why vision problems are so common in cerebral palsy, it helps to understand what cerebral palsy actually is. CP is caused by damage to the developing brain, usually before, during, or shortly after birth. This damage affects the brain’s ability to control movement and posture, but the brain also controls vision.

Vision isn’t just about whether the eyes themselves work properly. It’s about the brain’s ability to receive visual information from the eyes, process that information, and make sense of what’s being seen. When the parts of the brain responsible for vision are damaged, a child can have perfectly healthy eyes but still struggle to see clearly or understand what they’re looking at.

Additionally, the same types of brain injuries that cause CP (such as lack of oxygen to the brain, bleeding in the brain, or damage to the brain’s white matter) often affect the areas responsible for controlling eye movement and visual processing. This is why vision problems and cerebral palsy so often occur together.

What Types of Vision Problems Occur with Cerebral Palsy?

Children with cerebral palsy can experience a range of vision issues, from problems with the eyes themselves to difficulties with how the brain processes visual information. Here are the most common types:

Cerebral Visual Impairment in Children with CP

Cerebral visual impairment, or CVI, is the most common cause of vision problems in children with cerebral palsy. Unlike conditions that affect the structure of the eye, CVI results from damage to the brain’s visual processing areas, particularly the occipital lobes at the back of the brain.

With CVI, the eyes may work normally, but the brain has trouble interpreting what the eyes see. This can be confusing for families because a standard eye exam might show that the eyes themselves are healthy, yet the child clearly struggles with vision.

Children with cerebral visual impairment may experience:

• Difficulty focusing on objects or following them with their eyes
• Loss of parts of their visual field, meaning they may not see objects in certain areas even though their eyes are pointed in that direction
• Trouble recognizing familiar faces, shapes, or places
• A tendency to use peripheral (side) vision rather than looking directly at things
• Difficulty with visually complex environments, such as busy rooms or patterned backgrounds
• Better vision on some days than others, or vision that seems to fluctuate with fatigue or attention

CVI exists on a spectrum. Some children have mild forms that improve significantly with therapy and environmental adaptations, while others have more severe impairment that requires ongoing support.

Strabismus and Eye Alignment Issues

Strabismus, commonly called “crossed eyes” or “wandering eyes,” occurs when the eyes don’t align properly and point in different directions. This condition affects up to 50% of children with cerebral palsy.

Strabismus isn’t just cosmetic. When the eyes don’t work together, it affects depth perception and can make it difficult to judge distances or navigate spaces. If one eye consistently turns in or out, the brain may start to ignore the input from that eye to avoid double vision, which can lead to amblyopia or “lazy eye.” This is a condition where vision in one eye becomes weaker from lack of use.

Many cases of strabismus can be treated with glasses, eye patches, vision therapy, or surgery to realign the eye muscles. Early detection and treatment are important because the visual system is most adaptable during early childhood.

Refractive Errors

Refractive errors refer to common vision problems caused by how the eye focuses light. These include:

• Myopia (nearsightedness), where distant objects appear blurry
• Hyperopia (farsightedness), where close objects are harder to see clearly
• Astigmatism, where the cornea has an irregular shape, causing overall blurred vision

Children with cerebral palsy have higher rates of refractive errors compared to children without CP. The good news is that these conditions are usually straightforward to correct with glasses or contact lenses. Regular vision exams ensure that refractive errors are caught early and don’t interfere with learning and development.

Nystagmus and Involuntary Eye Movements

Nystagmus is a condition where the eyes make repetitive, involuntary movements. Often these movements are side to side, but sometimes up and down or in a circular pattern. This makes it difficult for a child to maintain a steady gaze on an object.

Nystagmus is more common in children with more severe forms of cerebral palsy. While it can’t usually be cured, strategies like positioning, lighting adjustments, and sometimes surgery or medication can help reduce its impact on daily life.

Which Children with Cerebral Palsy Are at Higher Risk for Vision Problems?

Not all children with cerebral palsy face the same level of risk when it comes to vision impairment. Certain factors increase the likelihood and severity of vision issues:

Severity of motor impairment: Children with more severe CP, particularly those with limited mobility or significant muscle tone issues, tend to have higher rates of vision problems. This makes sense because greater motor impairment often reflects more extensive brain injury.

Type of cerebral palsy: Quadriplegic CP (affecting all four limbs) and bilateral spastic CP carry higher risks for vision complications compared to other types.

Brain injury type: Children who experienced hypoxic-ischemic encephalopathy (brain injury from lack of oxygen), periventricular leukomalacia (damage to the brain’s white matter), or intraventricular hemorrhage (bleeding in the brain) are at increased risk for both CP and vision impairment.

Prematurity: Babies born extremely premature face higher risks for both cerebral palsy and vision problems. The earlier the birth, the greater the risk, as the visual pathways in the brain are still developing during the last months of pregnancy.

Understanding these risk factors doesn’t change your child’s diagnosis, but it does underscore the importance of proactive vision screening and monitoring.

How Vision Problems Affect Daily Life for Children with CP

Vision impairment doesn’t exist in isolation. It affects nearly every aspect of a child’s development and daily functioning.

Learning and education: Vision problems can make it harder for children to read, recognize letters and numbers, copy from a board, or complete visual tasks. Children with CVI may struggle in visually cluttered classrooms or have difficulty shifting attention between different visual tasks.

Social interaction: Recognizing faces, reading social cues, and making eye contact can all be affected by vision problems. Children may appear less engaged or responsive, not because they aren’t interested, but because they genuinely can’t see or process what’s happening around them.

Mobility and safety: Vision impairment makes it harder for children to navigate their environment safely. Depth perception issues from strabismus, visual field loss from CVI, or general blurriness from uncorrected refractive errors all increase the risk of bumps, falls, and difficulty moving confidently through space.

Fine and gross motor skills: Vision and motor skills are deeply connected. Tasks like reaching for objects, feeding, playing with toys, and later activities like writing all require visual guidance. When vision is impaired, motor skills can be even more challenging for children who already struggle with movement due to CP.

Recognizing how vision affects these areas helps families and care teams provide better support and realistic expectations while working toward meaningful goals.

The Importance of Vision Screening for Children with Cerebral Palsy

Given how common vision problems are in children with CP, regular and thorough vision screening should be a standard part of care, not an afterthought.

The CDC, National Institutes of Health, National Eye Institute, and American Academy of Pediatrics all emphasize the critical importance of vision screening and specialized assessment for children with cerebral palsy. These organizations recognize that vision impairment can significantly impact development and that early identification leads to better outcomes.

Unfortunately, vision problems in children with CP can be easy to miss, especially in the early years when there are so many other medical concerns to address. Young children can’t always communicate that they’re not seeing well, and some vision issues, particularly CVI, don’t show up on standard vision tests.

That’s why specialized assessment is important. A pediatric ophthalmologist or neuro-ophthalmologist with experience in cerebral palsy and developmental disabilities can conduct more comprehensive testing that looks beyond basic eye health to assess visual function and processing.

Vision screening should begin early and continue regularly throughout childhood, as some vision issues may not become apparent until a child is older or trying to complete more complex visual tasks.

What Can Be Done About Vision Problems in Cerebral Palsy?

While vision impairment in cerebral palsy can’t always be completely corrected, there is a great deal that can be done to improve function, support development, and enhance quality of life.

Corrective lenses: For refractive errors, glasses or contact lenses can make an enormous difference. Some children resist wearing glasses at first, but consistent use helps their brain learn to see more clearly.

Treatment for strabismus: Depending on the severity and type, strabismus can be treated with glasses, prisms, patching (covering the stronger eye to strengthen the weaker one), vision therapy, or surgery to adjust the eye muscles.

Vision therapy: This involves structured activities designed to improve visual skills like tracking, focusing, and coordination between the eyes. For children with CVI, vision therapy often focuses on helping the brain better process and use visual information.

Environmental modifications: Simple changes can make a big difference for children with vision impairment. These might include reducing visual clutter, using high-contrast materials, improving lighting, positioning objects in the child’s best visual field, or giving extra time for visual processing.

Assistive technology: Devices and tools ranging from magnifiers to screen readers to specialized computer software can support learning and independence as children grow.

Educational support: Children with vision impairment may qualify for services through an Individualized Education Program (IEP) or 504 plan. A teacher of students with visual impairments can provide strategies and accommodations to support learning.

The key is early intervention. The younger a child is when vision issues are identified and addressed, the better the brain can adapt and the more progress is possible. Vision is a learned skill, and the visual system is most flexible during the early years of life.

Moving Forward with Knowledge and Support

Learning that cerebral palsy can affect your child’s vision adds another layer to an already complex diagnosis. It’s one more thing to monitor, one more specialist to see, one more area where your child may need extra support.

But knowledge is power. Understanding the connection between CP and vision problems means you can be proactive rather than reactive. You can advocate for thorough vision screening. You can watch for signs that your child is struggling visually. You can seek out specialists who understand the unique vision challenges that come with cerebral palsy. And you can implement strategies and interventions that genuinely help your child see and understand their world more clearly.

Vision is how we learn about our environment, connect with others, and move through space. When vision is impaired, addressing it isn’t a luxury. It’s a fundamental part of supporting your child’s development and helping them reach their full potential.

If your child has cerebral palsy and hasn’t had a comprehensive vision evaluation, or if you’ve noticed signs that they may be struggling to see, talk to your child’s doctor about a referral to a pediatric ophthalmologist or neuro-ophthalmologist. The sooner vision issues are identified, the sooner you can access the support and interventions that can make a real difference in your child’s life.