Early visual training and environmental adaptation for infants with visual impairment

AIM To evaluate the effectiveness of early visual training and environmental adaptation onvisual function and neurological development in infants with visual impairment. METHOD This was a pilot intervention clinical trial study. Thirty infants (mean age 5.9mo, SD2.1mo, range 4–11mo; 16 males, 14 females) with peripheral visual impairment (PVI,n=15) orcerebral visual impairment (CVI,n=15) participated in a 6-month visual interventionprogramme. Thirty matched infants (mean age 6mo, SD 1.4mo, range 4–9mo; 18 males, 12females) served as a comparison group. Primary outcome measures were visual acuity,contrast sensitivity, and qualitative ocular motor functions. Secondary outcomes were scoreson the Griffiths Mental Developmental Scales (GMDS). RESULTS The treatment group showed a significant improvement in all the primary outcomes(p<0.01). The comparison group improved only in visual acuity and contrast sensitivity(p<0.01). The treatment group showed greater improvement than the comparison group invisual fixation (p=0.033) and smooth pursuit (p<0.01). The CVI subgroup showed greaterimprovement in visual acuity than the PVI subgroup (p<0.01). GMDS subscales of hand–eyecoordination (p=0.01) and performance (p<0.01) increased in the treatment group, while thetotal score of the comparison group decreased, driven by language (p=0.039) and hand–eyecoordination (p=0.025) subscales. INTERPRETATION Results suggest that, in infants with visual impairment, visual function andcertain developmental outcomes improve in response to early visual training andenvironmental adaptation, in an interactive contex