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Infant Eye Exam Basics

Did you know infants should have their first comprehensive eye exam by 6 months?

Why so young you ask? Vision development is a crucial part of your baby’s overall development. It affects areas such as fine and gross motor skills, cognitive and language development and even your baby's emotional development.

At six months, it is easier for an Optometrist to assess your child’s development and determine if a vision issue may be present because developmental milestones are more obvious during this stage of growth and learning. Early intervention at this age lessens damage that could lead to lifelong vision issues.

Infant Eye Exams

During an infant eye exam an Optometrist will be checking the health of your baby's eyes and looking for anything that might interfere with normal and continuing vision development. This includes looking at:

Age appropriate Visual Acuity
Refractive Status
Eye Movement (eye motility)
Eye Alignment/Binocular Potential (eye teaming)
Visual Integration/Hand-Eye Coordination
Eye Health

Be prepared to answer questions about your child's birth, health history and family history. During the eye exam you will be asked to hold your baby while the optometrist examines their eyes--be prepared to participate in activities or games that help the optometrist get a thorough look at your baby's vision skills.

Vision Skills Your Baby Is Developing

In the first six months, infant eyes are developing the ability to:

work together
focus clearly at different distances quickly, accurately, and for sustained periods of time
smoothly follow moving objects and to move accurately from one object to another.

At Birth:

your baby sees only in black and white and shades of gray
a newborn infant's eyes don't yet have the ability to accommodate or focus on near objects

During the First Month:

one week after birth, they can see red, orange, yellow and green
it takes a little longer for them to be able to see blue and violet
it is normal for your baby's eyes to sometimes appear to not be working together as a team yet. For example, one eye may occasionally drift inward or outward from proper alignment

At 2-3 Months:

develop sharper visual acuity during this period, and their eyes are beginning to move better as a team
learning how to shift their gaze from one object to another without having to move their head

4-6 months:

see more distinctly and are developing depth perception
move their eyes quicker and more accurately to follow moving objects

Visual acuity improves from about 20/400 at birth to approximately 20/25 at 6 months of age
Color vision should be similar to that of an adult by six months

7-12 months:

infants become mobile and begin learning how to coordinate their vision with their body movements

infant's eyes also begin to change color during this time

You can help your baby's vision development with simple games and activities.

What to Watch for...

Eye alignment problems

It takes a few months for an infant's eyes to develop eye teaming skills. However, if you feel one of your baby's eyes is misaligned constantly or does not move in synch with the other eye, contact your family doctor or optometrist as soon as possible.

Some terms you may hear from your Optometrist:

Amblyopia or lazy eye

Astigmatism

Hyperopia or farsightedness

Myopia or nearsightedness

Strabismus

Premature Infants

Premature babies have a greater risk of developing eye problems than full-term babies so it is extremely important for them to have a comprehensive eye exam at 6 months. Two of the main vision concerns with a premature baby are:

Retinopathy of prematurity (ROP): the abnormal replacement of normal tissue in the retina with fibrous tissue and blood vessels. ROP can cause scarring of the retina, poor vision, retinal detachment and even blindness. All premature babies are at risk of ROP.

Nystagmus: the involuntary, back-and-forth movement of both eyes which usually causes the eyes to drift slowly in one direction and then "jump" back in the other direction. The eye movements are usually horizontal, but they can be diagonal or rotational as well. It can be present at birth, or it may develop weeks to months later.