# Grading visual impairment in children with brain injury

> **NIH NIH R01** · WINIFRED MASTERSON BURKE MED RES INST · 2020 · $622,213

## Abstract

PROJECT SUMMARY/ABSTRACT
Visual impairment in children due to brain injury -Cerebral Visual Impairment (CV)- is difficult to objectively
assess because children at risk for CVI often lack the requisite verbal and cognitive skills to participate in
standard visual assessment procedures. As a result, CVI is commonly diagnosed through subjective
evaluations of a child’s gaze-derived reactions to different forms, colors and movements, which has limited
insight into its pathophysiology and potential for remediation. Thus, there is a critical need to objectively
quantify visual function after brain injury in children, and to characterize how visual impairment changes over
time. This research project will evaluate the utility of novel tools we have developed to rapidly and objectively
quantify visual function and diagnose CVI from eye movements in brain-injured children, independent of their
ability to pay attention and communicate. The system uses a computer to display visual stimuli, and an eye
tracking device to measure where a subject is looking. For spatial visual measures (i.e. acuity and contrast
sensitivity) we smoothly move a visually interesting band-limited circular image on a computer screen, and an
adaptive algorithm evaluates the extent to which the eyes move in concert with the image. When a child
smoothly follows the image with their eyes for a few frames -which provides objective evidence that they can
see it- stimulus features are changed in real-time to a higher spatial frequency (for acuity) or lower contrast (for
contrast sensitivity) until they can no longer follow, which quantifies the limit of their ability in seconds. A variant
of the methodology is also able to rapidly quantify gaze diagnostics, such as the velocity, latency and spatial
precision of eye movements. Together, these methodologies are able to objectively classify and grade CVI
based on visual measures that are rooted in the known physiology of the visual system, and are widely used to
evaluate other visual diseases. Our goal in this study is to validate the feasibility of our new approach as a
differential diagnostic and prognostic tool for CVI. For this we will evaluate our new gaze-based measures
against widely used clinical assessments, to identify and grade visual impairment in children hospitalized for
brain injury, and repeat the measures longitudinally. We expect that our approach will be able to identify and
grade CVI in many brain-injured children better than current clinical procedures, and better predict the probable
course of visual recovery. This evidence-based approach is expected to set the stage for future clinical studies
aimed at objectively evaluating the efficacy of therapeutic interventions for CVI.

## Key facts

- **NIH application ID:** 9937724
- **Project number:** 5R01EY030156-02
- **Recipient organization:** WINIFRED MASTERSON BURKE MED RES INST
- **Principal Investigator:** Glen Thomas Prusky
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $622,213
- **Award type:** 5
- **Project period:** 2019-06-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9937724

## Citation

> US National Institutes of Health, RePORTER application 9937724, Grading visual impairment in children with brain injury (5R01EY030156-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9937724. Licensed CC0.

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