Signs of Vision or Hearing Problems

Sight Lines

When James Ryan was 10 months old, his mother, Eileen, noticed a slight crossing of his left eye that would come and go throughout the day. She brought it to the attention of her pediatrician, who referred James to a pediatric ophthalmologist, a physician who specializes in treating eye conditions in children. The diagnosis: strabismus, a condition in which the eyes are misaligned, crossed, or wandering -- the result of the muscles being weaker on one side. Left untreated, strabismus causes permanent vision loss.

Now 2 years old, James wears eyeglasses to correct the problem, but his doctor hasn't ruled out the use of an eye patch or even surgery at a later date. While the prospect of surgery makes his mom nervous, she's glad she caught the problem early. "Don't assume that the doctor is going to notice everything," says Ryan of Cleveland Heights, Ohio. "In our case, James's eye wasn't crossing all the time and never in the doctor's office. But once we pointed out the problem, he didn't hesitate to refer us to a specialist."

While it's not normal for an older baby's eyes to cross, you will probably notice that your newborn's eyes will cross or wander. In fact, because young babies can't yet focus their eyes together when looking at an object, they actually see two images of everything.

They'll outgrow this (and the accompanying eye crossing) within the first few months as eye coordination improves. Babies also enter the world with weak vision -- ranging from 20/1,200 to 20/1,600. That means a newborn can only make out light, movement, and high-contrast colors such as black and white (he can't see in color yet), but not fine details. During the first few months, you'll notice that your baby will focus on your hairline, eyes, and mouth features where there's a big contrast in color from the surrounding area.

Your infant can see up to a foot in front of him, which is just about right for studying your face during those late-night feedings. Your baby prefers human faces to all other forms of visual stimulation, so be sure to give him plenty of face time throughout your day.

Surround him with interesting objects that have bold patterns and highly contrasting colors such as a black-and-white crib mobile or a blanket with a geometric pattern. He won't be able to see those baby pastels just yet -- but he'll be drawn to deep primary colors like red.

By 3 months, your baby will begin to follow a moving object with his eyes, and not just watch a toy or other item directly in his line of vision. Your baby's ability to perceive the full range of colors comes in at around 4 months. His sense of depth perception and understanding that things get bigger when you get closer to them (and smaller when you're far away) comes when he begins to crawl.

Vision develops gradually -- in fact, most children don't attain 20/20 vision until the ages of 3 to 5, says Craig A. McKeown, MD, a pediatric ophthalmologist with the Bascom Palmer Eye Institute at the University of Miami.

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