Retinoscopy prior to cycloplegia can identify impaired accommodation and reveal manifest hypermetropia not corrected by the accommodative reflex. The provision of spectacles can give gratifying results. Sorting out a complex visual scene can take a long time. Enlargement and simplification of educational material, with sequential presentation against a plain background can be recommended. A child may be able to see a small toy in the distance but be unable to recognise a close relative in a group.
Affected children compensate by voice recognition or by recognising shoes or brooches.
Problems with reading are best assessed by an expert in visual impairment and education who takes into account the optimal size and lighting required for a maximum comfortable reading speed and who recognises the nature of specific reading disorders. Limited mobility and constant supervision do not give opportunities to develop navigational skills. Education strategies and mobility training which compensate by using, for example, language memory for standard routes, are essential. Visual memory is used for copying tasks which can prove difficult for children with cerebral visual impairment. In new environments, affected young children may have impaired face recognition and navigation.