Seven Challenges for People with Cortical Visual Impairment

People with Cortical Visual Impairment face unique daily challenges that current assistive technologies often fail to address adequately. Based on focus group discussions with CVI participants, we've identified seven major areas where better technological support is urgently needed.

1. Unawareness

The Challenge

People with CVI may be completely unaware of objects, people, or text in their environment, even when these are within their visual field. This includes:

Missing objects or people in plain sight
Not noticing text on signs or documents
Being unaware of moving objects (Akinetopsia)
Hemianopsia (loss of half the visual field)
Hemineglect (ignoring one side of space)

Current Strategies

Using long canes for navigation, sensor lights for hazard awareness, relying on routine and familiarity.

Technology Gaps

Need for systems that can intelligently detect and alert users to important elements in their environment without overwhelming them.

2. Locating

The Challenge

"You cannot find what you're looking for, even though it's right in front of you." Visual clutter makes this especially difficult. Issues include:

Difficulty finding specific objects in cluttered environments
Spatially missing when reaching for objects
Struggling to control visual fixation
Problems locating people in crowds

Current Strategies

Painting objects bright colors, labeling items, organizing spaces to reduce clutter.

Technology Gaps

Need for object highlighting systems, directional guidance, and clutter reduction technologies.

3. Identifying

The Challenge

Difficulty recognizing familiar objects, people, or expressions due to simultanagnosia (seeing parts but not the whole). Challenges include:

Not recognizing familiar faces
Difficulty identifying common objects
Problems reading facial expressions
Challenges distinguishing between similar items

Current Strategies

Using the "wagon wheel" approach - looking around faces to refresh the image, building up visual scenes slowly.

Technology Gaps

Need for face and object recognition aids, feature enhancement tools, and identification assistance.

4. Reading

The Challenge

Text recognition and reading present significant difficulties beyond just finding and locating text:

Struggling with certain fonts and formats
Difficulty with colored or stylized text
Problems maintaining reading flow
Challenges with text on non-standard backgrounds

Current Strategies

Using plain fonts only, converting text to high contrast, avoiding reading when possible, using audiobooks.

Technology Gaps

Need for intelligent text standardization, real-time text enhancement, and seamless text-to-speech integration.

5. Sensory Overload

The Challenge

Multiple sensory inputs can overwhelm the brain's processing capacity, causing:

Stress and tunnel vision during conversations
Difficulty maintaining eye contact
Challenges filtering background noise and visual distractions
Visual attention difficulties

Current Strategies

Consciously managing visual attention, looking away during conversations, using voice controls to avoid screens.

Technology Gaps

Need for sensory filtering systems, overload detection, and attention management tools.

6. Mobility

The Challenge

Navigation and movement present unique difficulties:

Visuomotor coordination problems
Difficulty navigating unfamiliar environments
Challenges with depth perception
Need to "map" new spaces through exploration

Current Strategies

Memorization of routes, advance planning, orientation and mobility training, using walkers for stability.

Technology Gaps

Need for intelligent navigation aids that understand CVI-specific mobility challenges.

7. Luminance and Contrast Sensitivity

The Challenge

Light and contrast issues significantly impact vision:

Difficulty with subject/background separation
Glare from sunlight and bright lights
Problems with light streams at night
Visual snow (persistent visual static)
Difficulty perceiving muted colors

Current Strategies

Improving home lighting, using bright colors for important objects, wearing sunglasses and hats, avoiding night driving.

Technology Gaps

Need for dynamic brightness adjustment, glare reduction, and enhanced contrast management systems.

The Impact on Independence

These seven challenges collectively lead to reduced independence and increased reliance on others. While this dependence isn't inherently problematic, it becomes a concern when it prevents people from achieving their full potential and participating fully in daily life.

Current assistive technologies, primarily designed for ocular vision impairments, often fail to address these brain-based visual processing challenges. This gap highlights the urgent need for CVI-specific technological innovations.