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Does my baby need an eye examination?

Does my baby need an eye examination?

darrenBy Dr. Darren Stoler

I have often been asked by new Moms “how do I know if my baby can see?” or “does my baby need an eye examination?” The answer is a little complicated, partly because the development of the visual system in newborn babies is a slow process, and complicated by nature.

Contrary to popular belief, babies aren’t born into this world able to see right away. It takes many months for the eyes and the brain to learn how to speak the same language. With each passing month your baby’s vision slowly improves, and as a result, he or she interacts more with their surroundings as time goes by. By about one year of age, visual acuity finally reaches normal adult levels. Until then, there are many milestones to look out for to ensure your baby’s eyesight is developing properly – just like the other milestones you are likely to be familiar with such as sitting up on their own at around 6-8 months old, or taking their first steps at around 1 year old.

These are the visual milestones to look out for in your baby –

  • At birth your baby’s eyesight is quite poor. That does not mean he or she cannot see at all, but that his/her brain is only starting to learn how to interpret the signals sent to it from the eyes. Within the first month of life, your baby should turn their head towards a light source. When something bright or colourful is in your baby’s eyeline, he/she may open his/her eyes wider and look directly at it.
  • Within the first 3 months, your baby should start reaching out for interesting objects that he/she sees, and if you bring an interesting object closer to your baby’s face, he/she should focus on it by accommodating – the eyes should come closer together, and the pupils will get smaller. They should also start to look you in the eyes, smile at your presence, copy your facial expressions, and follow visually interesting objects around the room.
  • At around 4 months old, your baby should blink to protect his/her eyes when there is a sudden movement towards their face.
  • At 6 months your baby should be reaching out to be picked up by you, and pointing at objects that catch their interest across the room.
  • At 9 months, if an object that has your baby’s attention falls to the ground, he/she should follow its movement and look to see where it landed.
  • At 12-15 months, their vision should be near normal adult vision. Visually directed walking normally starts around this time, as well as scribbling with crayons, routinely picking up objects between their thumb and forefinger, and showing visual interest in picture-books. Your baby should also recognise faces that are familiar to them at this age.
  • At 24 months smooth-pursuit of an object moving from left to right should be normal.

The visual system continues to develop slowly over the next 7 years of life, but there are normally no new milestones to watch out for. All newborn babies should have their eyes checked as part of a routine examination by your paediatrician, but if your baby is not consistently meeting the above milestones, or you have any concerns, they should be seen by an ophthalmologist. Most importantly, there are certain warning signs to be aware of: if you notice any of the following, your baby should be seen urgently by your ophthalmologist –

  • Any unusual repetitive movements of the eyes (called nystagmus).
  • Any squint, even if it is not there all the time. (This can be normal and transient in the first 3 months of life, but should still be checked).
  • If the pupil of the eye, which is normally black, is white, cloudy, or discoloured.
  • If one eye is larger than, or looks different to, the other eye.
  • Constant eye-rubbing or red eyes.
  • Constant tearing or discharging eyes.

Your paediatrician should check your baby’s eyes once more before he/she turns one year old. Further screening of vision should take place when your child gets a little older, and enters pre-school, but that is another topic altogether – perhaps for another article in the future. If there are any topics you would like to be discussed, or have any questions on eyes and eye health, please let SA MOMS know and they will pass it on.

Please note: This article is not a replacement for individualised medical advice. Always contact your own eye doctor or other professional healthcare provider if you have a question concerning your or your family’s health. RELIANCE ON ANY INFORMATION ON THIS WEB SITE IS AT YOUR OWN RISK. DR. STOLER IS NOT RESPONSIBLE OR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS, DRUG AND DEVICE APPLICATION OR OTHER INFORMATION, SERVICES, OR PRODUCTS THAT YOU OBTAIN THROUGH THIS SITE.