title: Setting up of a cerebral visual impairment clinic for children: Challenges and future developments.
abstract: OBJECTIVE
  The aim of this study is to describe the setting up of a cerebral visual impairment (CVI) clinic in a tertiary care hospital in South India and to describe the spectrum of cases seen.
  
  
  METHODS
  The CVI clinic, set up in February 2011, receives interdisciplinary input from a core team involving a pediatrician, neurologist, psychiatrist, occupational therapist, pediatric ophthalmologist, and an optometrist. All children, <18 years of age, with cerebral palsy (CP), learning disability, autism, neurodegenerative diseases, and brain trauma are referred to the clinic for functional vision assessment and opinion for further management.
  
  
  RESULTS
  One thousand four hundred and seventy-eight patients were seen in the CVI clinic from February 2011 to September 2015. Eighty-five percent of the patients were from different parts of India. In the clinic, 61% had CP, 28% had seizure disorders, autism was seen in 9.5%, and learning disability, neurodegenerative conditions, and brain injury together constituted 1.5%. Most of the children (45%) had moderate CP. Forty percent of CVI was due to birth asphyxia, but about 20% did not have any known cause for CVI. Seventy percent of patients, who came back for follow-up, were carrying out the habilitation strategies suggested.
  
  
  CONCLUSIONS
  Average attendance of over 300 new patients a year suggests a definite need for CVI clinics in the country. These children need specialized care to handle their complex needs. Although difficult to coordinate, an interdisciplinary team including the support groups and voluntary organizations is needed to facilitate the successful implementation of such specialized service.
authors.affiliation: Department of Ophthalmology, Cerebral Visual Impairment Clinic, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Swetha Sara
authors.initials: SS
authors.lastname: Philip
mesh_terms: D019575:Blindness, Cortical / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D002547:Cerebral Palsy / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014792:Visual Acuity