What he should be seeing -- and what may signify a problem.
What Your Baby Should See
Newborn babies can only see objects close up, optimally at a distance of about 8 to 12 inches. Researchers point out that this is about the distance from a newborn's eyes to his mother's face as she feeds him. At first, a newborn's eyes don't work together, and some studies suggest that he actually sees two images of each object. But this corrects itself around the third month. Babies also can't see in color until 4 months of age, so at first your child will be most interested in black-and-white photos or toys; objects with high-contrast patterns, such as stripes or checks; and, of course, human faces.
By 4 months of age, your baby will also begin to use his eyes to coordinate his hand movements. Your child's ability to distinguish depth and detail and to track an object will also improve over the first year.
Types of Vision Problems
Your doctor will examine your baby's eyes and vision at each well-baby visit. If she finds anything questionable, she may refer you to an ophthalmologist or other specialist. Here are the major vision problems that the doctor is testing for:
- Strabismus: This is the result of an imbalance in the alignment of the eye muscles. It occurs in about 2 percent of the population. A newborn's eyes normally tend to wander, but your baby should be able to coordinate them by 3 to 6 months. If you see one of your child's eyes moving independently, or if one eye looks out while the other looks in, it could be a sign of strabismus.
- Blocked tear ducts: This affects one in 100 babies at birth, causing them to tear a lot or experience mucus discharge. Often the problem clears up on its own, though your doctor may recommend that you massage the tear duct or apply warm compresses to help it open. If your child gets an infection from the obstructed duct, the doctor will also prescribe antibiotic drops to help it clear up. If the blockage persists or gets worse, you may be referred to a specialist who can surgically open the tear duct in a simple office procedure.
- Amblyopia: Also known as "lazy eye," amblyopia occurs when the vision in one eye is weak, causing the baby to use the other eye almost exclusively. It affects about 4 percent of newborns, and if detected and treated early it is completely reversible. (If left untreated past the age of 5 or 6, it could cause blindness in the weaker eye.) Amblyopia can be caused by some misalignment of the eyes, by something that obstructs the eye (like a cataract), or by a focusing difficulty. Once the doctor has treated the underlying problem, she'll probably either patch the good eye or prescribe eyedrops to blur its vision in order to force the child to use his weaker eye.
- Cataracts: Cataracts are a problem usually associated with a grandpa -- not a baby. But some newborns are born with this clouding of the lens, usually because of a genetic predisposition or as the result of a viral infection, such as rubella, that their mother suffered during pregnancy. If untreated, cataracts can cause vision loss. Generally, surgery is used to remove the cataract in the first month after birth. To compensate for the loss of the clouded lens, the baby is fitted with eyeglasses or a contact lens.
Signs of Vision Impairment
Here's an age-by-age guide of signs to watch out for:
- Doesn't stare at a human face or a vividly patterned object
1 to 2 months
- Will not track an object
- Eyes wander or appear crossed or crooked
3 to 4 months
- Can't see you from across the room
- Doesn't reach for objects
- Doesn't see objects unless they are held close
- Turns sideways or tilts head to look at objects
- Has persistent redness in or around the eyes, or swelling or discharge from the eyes
- One or both eyelids droop
- Iris of one or both eyes appears cloudy
- Shows excessive tearing, light sensitivity, or blinking
- Rubs eyes frequently
- Sustains an eye injury
Copyright © 2002 AmericanBaby.com.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.