Cerebral Visual Impairment (CVI) is the most prevalent cause of visual impairment among children in the UK. Current management strategies often involve lengthy assessments unsuitable for immediate application at diagnosis. Parents' feedback highlights the need for readily available advice. This study aimed to use the Delphi method to create concise, three-word phrases representing effective strategies for managing common visual challenges in children with CVI, offering immediate support to families and ophthalmologists.

Existing literature on CVI management often consists of extensive inventories used in specialized settings. There's a recognized need for readily accessible information for families and educators, particularly at the time of diagnosis, to bridge the gap between healthcare and educational support. While ophthalmologists may not develop specific interventions, they can provide general recommendations on utilizing vision more effectively. The Delphi technique, chosen for its ability to gather expert opinions anonymously and iteratively, aids the development of novel strategies through consensus-building.

Twelve experts (healthcare professionals, educators, and individuals with lived experience) participated in a four-round Delphi study. Round 1 involved ranking the usefulness of strategies for various CVI-related symptoms using a Likert scale. Round 2 focused on generating three-word phrases for the top-ranked symptoms. Round 3 involved voting on the best three-word phrase for each symptom. Round 4 revisited items lacking consensus, providing participants with the most popular options from Round 3. Consensus was defined as 70% agreement. Ethical approval was obtained from the University of Bradford's Research Ethics Panel.

The study achieved high response rates (91-92% across rounds, except for Round 2 at 67%). Ten three-word phrases reached consensus and represent strategies for common CVI-related symptoms. These include: * **Big Bold Bright:** For low contrast or small object vision problems. * **Keep it Still:** For difficulties seeing moving objects. * **Eyes or Ears:** For challenges integrating visual and auditory information. * **Show it High:** For problems utilizing the inferior visual field. * **Better on Left/Right:** For difficulties using both visual fields equally. * **Clear the Clutter:** For problems processing multiple objects simultaneously. * **Keep It Short:** For difficulties maintaining visual attention. * **Give Me Time:** For delayed responses to visual stimuli. * **My Vision Varies:** For fluctuating visual abilities. * **Just One Thing:** For difficulties attending to multiple objects at once. These phrases were intended to serve as initial guidance at diagnosis and are considered appropriate for children of all developmental and visual abilities.

The ten three-word phrases offer a concise and readily accessible set of strategies for supporting children with CVI. This simple approach aims to improve patient experience by providing immediate, practical advice during diagnosis, a significant improvement over existing, lengthier assessments. The study's strength lies in its use of the Delphi method and its focus on practicality. The phrases address the most commonly observed CVI features across various settings (education, ophthalmological examinations, parental reports).

This study successfully generated a set of ten concise, three-word phrases representing effective strategies for common visual dysfunctions in children with CVI. These phrases can help ophthalmologists provide immediate, easy-to-understand advice to families at the time of diagnosis. Further research is crucial to validate their effectiveness and impact on visual development in real-world settings.

The study's limitations include a relatively small panel of experts (12 participants). While within the recommended range for Delphi studies, a larger, more diverse panel could strengthen the findings. The purposive sampling method, while appropriate for Delphi studies, may limit the generalizability of the results. Further research is needed to evaluate the real-world effectiveness and impact of these strategies on visual development.