Infant Vision: Birth to 24 Months of Age

          Babies learn to see over a period of time, much like they learn to walk and talk. They are not born with all the visual abilities they need in life. The ability to focus their eyes, move them accurately, and use them together as a team must be learned. Also, they need to learn how to use the visual information the eyes send to their brain in order to understand the world around them and interact with it appropriately.Infant Vision, Infant Vision: Birth to 24 Months of Age

          From birth, babies begin exploring the wonders in the world with their eyes. Even before they learn to reach and grab with their hands or crawl and sit-up, their eyes are providing information and stimulation important for their development.

          Healthy eyes and good vision play a critical role in how infants and children learn to see. Eye and vision problems in infants can cause developmental delays. It is important to detect any problems early to ensure babies have the opportunity to develop the visual abilities they need to grow and learn.

Parents play an important role in helping to assure their child's eyes and vision can develop properly. Steps that any parent should take include:

  • Watching for signs of eye and vision problems.
  • Seeking professional eye care starting with the first comprehensive vision assessment at about 6 months of age.
  • Helping their child develop his or her vision by engaging in age-appropriate activities.

Steps in Infant Vision Development

          At birth, babies can't see as well as older children or adults. Their eyes and visual system aren't fully developed. But significant improvement occurs during the first few months of life.

          The following are some milestones to watch for in vision and child development. It is important to remember that not every child is the same and some may reach certain milestones at different ages.

Birth to four months

  • At birth, babies' vision is abuzz with all kinds of visual stimulation. While they may look intently at a highly contrasted target, babies have not yet developed the ability to easily tell the difference between two targets or move their eyes between the two images. Their primary focus is on objects 8 to 10 inches from their face or the distance to parent's face.
  • During the first months of life, the eyes start working together and vision rapidly improves. Eye-hand coordination begins to develop as the infant starts tracking moving objects with his or her eyes and reaching for them. By eight weeks, babies begin to more easily focus their eyes on the faces of a parent or other person near them.
  • For the first two months of life, an infant's eyes are not well coordinated and may appear to wander or to be crossed. This is usually normal. However, if an eye appears to turn in or out constantly, an evaluation is warranted.
  • Babies should begin to follow moving objects with their eyes and reach for things at around three months of age.

Five to eight months

  • During these months, control of eye movements and eye-body coordination skills continue to improve.
  • Depth perception, which is the ability to judge if objects are nearer or farther away than other objects, is not present at birth. It is not until around the fifth month that the eyes are capable of working together to form a three-dimensional view of the world and begin to see in depth.
  • Although an infant's color vision is not as sensitive as an adult's, it is generally believed that babies have good color vision by five months of age.
  • Most babies start crawling at about 8 months old, which helps further develop eye-hand-foot-body coordination. Early walkers who did minimal crawling may not learn to use their eyes together as well as babies who crawl a lot.

Nine to twelve months

  • At around 9 months of age, babies begin to pull themselves up to a standing position. By 10 months of age, a baby should be able to grasp objects with thumb and forefinger.
  • By twelve months of age, most babies will be crawling and trying to walk. Parents should encourage crawling rather than early walking to help the child develop better eye-hand coordination.
  • Babies can now judge distances fairly well and throw things with precision.

One to two years old

  • By two years of age, a child's eye-hand coordination and depth perception should be well developed.
  • Children this age are highly interested in exploring their environment and in looking and listening. They recognize familiar objects and pictures in books and can scribble with crayon or pencil.

Signs of Eye and Vision Problems

          While many infant vision problems are only detectable by a pediatrician or an ophthalmologist, you can take a few steps to ensure early intervention on any potential issues:

  • Snap photos. While “red eye” isn’t the look you’re going for, this nuisance actually shows that baby’s eyes are correctly refracting light. Pictures that show whiteness in baby’s pupils, on the other hand, indicate a condition known as leukocoria, which may signal serious problems (such as a cataract or a tumor) that require attention from a pediatrician right away.
  • Watch for focus. In the first few months, it’s normal for a baby’s eyes to sometimes seem like they’re looking in different directions (a condition known as strabismus). However if this continues past 4 months, take your child to a pediatrician for an evaluation. Same goes if your baby doesn’t seem to focus on your face and instead appears to be looking through or around you, or if she consistently seems to be looking off to one side.
  • Check if she’s interested in objects. If by around month 4 your baby can’t track objects or by month 7 doesn’t seem interested in any new visuals you show her (like that bright new toy you just bought), check in with your doctor.
  • Monitor for other eye issues. Other symptoms that merit a trip to the doctor include bulging eyes, eyes that seem to quickly flutter up and down or side to side, constant redness or wateriness, sensitivity to light, itchy eyes or eye pain.

          If you notice any of the above or any other visual issues that don’t seem quite right, don’t hesitate to bring baby to the doctor for an exam.

Baby's First Eye Exam

          Even if no eye or vision problems are apparent, at about age 6 months, you should take your baby to your doctor of optometry for his or her first thorough eye examination.

Things that the optometrist will test for include:

  • excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism
  • eye movement ability
  • eye health problems.

          These problems are not common, but it is important to identify children who have them at this young age. Vision development and eye health problems are easier to correct if treatment begins early.

Sources:

  1. Infant Vision: Birth to 24 Months of Age
  2. How Your Baby Sees the World,  January 1, 2019

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