How Well Does Your Baby See?

By Dr. Carol Hong, OD, FCOVD

From Parenting on the Peninsula, May 2010; Reprinted with Permission

It may surprise you to know that newborn babies can barely see! And, although prenatal care and nutrition are vital for healthy eye and brain development, infants are not born with perfect eyesight.

Cooing and crawling are signs that indicate your infant’s language and motor skills are developing and maturing, but how can you tell if your child’s vision is doing the same?

What Can New Parents Expect

At birth, your baby’s eyes will be checked for signs of a cataract or any obvious congenital eye problems. Your pediatrician will most likely put antibiotic ointment in your baby’s eyes to prevent infection at birth, so vision will be blurry when they first open their eyes.

As your baby becomes more alert over the next few days, he or she will naturally focus at about 8-12 inches from their eyes. This is just about the distance from your face when you hold or feed them.

For the first few weeks of life, it’s normal for a baby to not follow a moving toy, such as a rattle, or your face with both eyes. For instance, one eye may drift in or out. This should not be a concern unless the eyes are always misaligned or the condition does not lessen over the next few months.

Excess tears are also normal for many infants because the tear drainage ducts may not have fully opened. They usually open on their own or with gentle massaging of the inner eye. If there is a constant eye turn, redness, crustiness, mucous discharge, or excessive tearing, you should discuss this with your family optometrist immediately.

Early Vision Examinations — Necessity

Did you know that your child does not need to be able to talk or read in order to have an eye exam? While your pediatrician may provide an important screening that is designed to detect gross eye abnormalities, it is also important to ensure your baby has a comprehensive eye assessment between 6 and 12 months.

Optometrists are trained to look at your infant’s visual development and eye health, utilizing specialized instruments and procedures, in a way that is really very entertaining to your baby.

Public health experts agree that visual development is most dramatic between 6 and 12 months of age and that, with a more thorough assessment, early detection can prevent and reduce the threat of serious vision impairments or permanent vision loss. Recent Center for Disease Control data shows that one in six infants have untreated eye and vision problems.

Thanks to Johnson & Johnson and the American Optometric Association there is a nationwide program called InfantSEE® which launched five years ago. With support from former president Jimmy Carter, honorary national chair and spokesperson, the InfantSEE® program offers no-cost vision assessments for all infants between 6-12 months of age.

During the InfantSEE® vision assessment the optometrist looks for signs of:

  • Retinoblastoma (eye cancer)
  • Severe Hyperopia (farsightedness)
  • Myopia (nearsightedness)
  • Congenital Glaucoma
  • Congenital Cataract
  • Amblyopia (lazy eye)
  • Strabismus (eye turn)

Even if a baby’s well-child exam by a pediatrician gives no indication that anything is amiss with vision, parents and caregivers still should schedule a well-baby Eye examination with an optometrist, between 6-12 months of age, to help ensure that these sight-threatening conditions are caught early.

Parents Can Encourage the Development of Good Visual Skills

1. Make eye contact often. Babies are naturally drawn to a person’s face, so talk to your baby while looking into their eyes and as you walk around the room.

2. Provide interesting visual stimuli. Decorate with bright colors, bold contrasting lines, and complex shapes.

3. Change their view often. In the crib, hang a mobile and change their position and the position of the crib itself.v

4. Stimulate both sides of the body. Move your infant’s arms or legs simultaneously, like riding a bicycle. Alternate feedings on right and left sides.

5. Practice visual skills. Play with reach-and-touch toys within about 8 to 12 inches. Have them look at the toy while moving it slowly in and out, from the left and right, and at a diagonal.

6. Make time for “tummy-time,” even if your infant complains. Research shows that supervised daily playtime while on the tummy is important for eye and motor coordination. You can make it more fun by engaging your baby in peek-a-boo or some other game and soon the complaints will disappear.

7. Encourage crawling. As anxious as you may be to have your child take his first steps, crawling is very important in developing eye-hand coordination and concentration.

8. Schedule an InfantSEE® assessment between 6-12 months of age. Thereafter, it is recommended to have a comprehensive eye exam at age three, before kindergarten, and every two years throughout your child’s academic career.

There are over 15 visual skills critical to reading and learning in addition to being able to see clearly (“20/20”). These visual skills critical to learning are developed during infancy and the toddler years. If your child is missing even one of these skills, reading and learning could become difficult and overall development may be affected.

To help ensure that your child has a lifetime of healthy vision, the San Mateo Optometric Society is dedicating an entire week, May 10th-14th, to promote the importance of preventing eye and vision conditions that can affect a baby’s visual development, threaten eyesight, and impact lifelong learning.

For more information on visual development, to find out about free lectures for parents and educators, as well as a complete list of symptoms of eye problems, visit www.familyvisioncare.org.

Carole L. Hong, OD, FCOVD, board certified in vision development, has been practicing in San Carlos for over 15 years. She is an expert in children’s vision, vision and learning, and treatment of vision problems for those with autism spectrum disorders, other developmental disabilities, head injury, and stroke. Dr. Hong can be reached at (650) 593-1661 or email@familyvisioncare.org. In addition to their Web site, www.FamilyVisionCare.org, more helpful information can be found at www.infantsee.org, and www.covd.org (College of Optometrist in Vision Development).