Your baby isn’t born with fully developed vision. They need to learn how to focus, train their eyes to track accurately and work together, and learn how to interpret the information that the eyes send to the brain. But how do you know what baby sees and whether their vision is developing as it should? As your little one can’t tell you when something’s not right with their eyesight, it’s crucial for you as a parent to be aware of the signs of potential vision problems. Early detection can make a big difference, so let’s explore what to look for and how to ensure your baby’s eyes are healthy.
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Your baby’s vision is so vital to their development, and vision problems can be difficult to detect at such a young age. This is why it is so important to have your baby’s eyes checked regularly with your baby’s doctor, as well as a more comprehensive eye exam between 6-12 months old with an optometrist. This ensures that any vision or eye problems are caught early and can be treated as soon as possible.
How Do I Know if My Baby Can See?
Common Signs of Vision Problems
- Excessive Eye Rubbing: If your baby frequently rubs their eyes, especially when not tired, it could indicate discomfort or vision issues.
- Poor Focusing: By around 3 months of age, babies should be able to follow a moving object with their eyes. If your baby struggles to focus on your face or a toy, it might be a sign of a vision problem.
- Abnormal Eye Movement: Watch out for unusual eye movements. If your baby’s eyes are constantly moving quickly from side to side (nystagmus), or if they don’t move together in a coordinated way, it’s important to get it checked.
- Extreme Sensitivity to Light: Babies naturally squint in bright light, but if your baby seems overly sensitive to light, it could be a concern.
- White Pupil: If you notice a white, gray, or cloudy color in the pupil of your baby’s eye (the central black part), seek medical attention. This could be a sign of an eye condition like cataract or something more serious. And let your doctor know if baby’s pupils shine white, yellow or black in a photo with a flash (eye shine is usually red).
- Lack of Eye Contact: While it’s normal for newborns to not make much eye contact, by around 2-3 months, they usually start to gaze at faces. An absence of eye contact could indicate a vision problem.
- Escessive Tearing: Take note of frequent tearing that occurs, even when your baby isn’t crying.
- Eye Turning: If one or both of your baby’s eyes consistently turn in (cross-eyed) or out (wall-eyed), it’s important to have it evaluated. Occasional misalignment is normal up to about 4 months of age, but persistent or frequent misalignment is not.
How Do You Test a Newborn’s Vision?
Some possible signs of vision concerns listed above are only for babies older than four months, because it’s developmentally normal for babies younger than that. So how can you tell if there’s an issue with your newborn’s eyes?
Take note of things on the above list that you can visualize, like cloudy or dull eyes, eyes that are red, warm, or inflamed, and pupils that shine a color other than red in flash photos. Otherwise, your doctor will examine your baby frequently during well check appointments.
Vision Problems an Optometrist Will Look For
Nearsightedness (Myopia)
Difficulty seeing objects far away. This is very rare in babies but becomes more common with age. Glasses can usually correct for it.
Farsightedness (Hyperopia)
Difficulty seeing objects up close. A small degree is normal in babies, but if it is severe or causes the eyes to cross, glasses may be needed.
Lazy Eye (Amblyopia)
Poor vision in an eye that either did not develop vision normally or lost vision because it wasn’t used. Anything that blurs the vision or causes the eyes to turn can result in a “lazy eye”. Doctors will often use a patch or special eye drops in the good eye to help strengthen the weaker one. Sometimes surgery can correct the muscles of misaligned eyes.
Crossed or Misaligned Eyes (Strabismus)
One eye may look straight ahead while the other turns in, out, up, or down. Treatment includes a combination of glasses, patches, and surgery, depending on the reason for the misalignment. If left untreated the brain may begin to ignore the crossed eye in order to see clearly.
Droopy Eyelid (Ptosis)
An eyelid that droops and cannot open wide enough to see clearly. It is likely that the eyelid muscles are too weak. Surgery can lift the eyelid and restore full vision.
Cataracts
A clouding of the clear lens inside the eye. In babies, this is typically due to a genetic condition, an abnormal development of the lens, an infection carried by the mother during pregnancy (chickenpox, rubella, etc.), or an injury to the eye during or after birth. Surgery is the only way to remove the cataract and clear the vision.
Glaucoma
A disease where damage to the optic nerve leads to vision loss. This damage is often caused by elevated pressure in the eye. When the eye creates fluid, but cannot efficiently drain that fluid, it builds up in the eye and the pressure causes damage to the optic nerve. Babies can be born with glaucoma (congenital glaucoma) or it can develop later (infantile glaucoma). It may be the result of a number of things including genetics, chronic steroid use, a health condition, trauma or injury to the eye, or a previous eye surgery. Surgery is needed in most cases to drain the fluid from the eye.
Astigmatism
An irregularly shaped cornea that can cause blurred vision. It is actually quite common in babies, but most correct themselves within a few years.
Remember, Early Detection Matters
Many vision problems in babies can be treated effectively, especially when caught early. Trust your instincts as a parent – if you think something might be off with your baby’s vision, it’s always better to get it checked.
As you nurture and watch your little one grow, keeping an eye on their eye health is just one of the many ways you’re providing the best care. Remember, you’re doing a fantastic job, and your attention to these details makes a world of difference in your baby’s development. Here’s to happy, healthy eyes and lots of beautiful sights to see together!
References:
- Abrahamsson, M., Fabian, G., & Sjostrand, J. (1988). Changes in astigmatism between the ages of 1 and 4 years: a longitudinal study. British Journal of Ophthalmology. 72(2), 145-149. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1041389/
- Childhood cataracts. (2018 Oct). National Health Service. https://www.nhs.uk/conditions/childhood-cataracts/
- Vision Screenings. (2016 July). American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Vision-Screenings.aspx#:~:text=As%20part%20of%20each%20well,At%203%20to%204%20years.
- Turbert, D. (2020 Jul). Childhood Eye Diseases and Conditions. American Academy of Opthalmology. https://www.aao.org/eye-health/tips-prevention/common-childhood-diseases-conditions
- Specific Eye Problems in Children. (2017 Jan). American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Specific-Eye-Problems.aspx
- Mukamal, R. (2020 Feb). Cataracts: Pediatric Cataracts. American Academy of Opthalmology. https://www.aao.org/eye-health/diseases/what-are-pediatric-cataracts
- Mukamal, R. (2019 Dec). 20 Things to Know About Children’s Eyes and Vision. American Academy of Opthalmology. https://www.aao.org/eye-health/tips-prevention/tips-children-eyes-vision
- Infant Vision: Birth to 24 Months of Age. American Optometric Association. https://www.aoa.org/healthy-eyes/eye-health-for-life/infant-vision?sso=y
- Warning Signs of Vision Problems in Infants & Children. (2016 July). American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Warning-Signs-of-Vison-Problems-in-Children.aspx
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