Assessment of vision in the newborn and infants is very important. Many eye and visual disorders in children need to be detected early as healthy eyes and good vision play a critical role in how infants and children learn to see.
Assessing vision in a baby
The parents might be the first to notice that something is wrong with the eyes or vision of the newborn. Parents should be aware what their child can see at various ages, but they should have realistic expectations about what a baby should be able to do by a certain age. The following might prove helpful:
All healthy babies should blink when a light is flashed in their eyes. If not, suspect a problem.
By six weeks all health babies should turn to a diffused light, such as a light coming from a window. If not, suspect a problem.
Between 6 weeks and 3 months, healthy babies should look at your face when 10-20 cm away (less than one foot). Their eyes should fix on, and follow, a dangling ball or toy. If not, suspect a problem.
Between 6 weeks and 4 months, a healthy baby watches an adult at 1.5 metres (5 feet). If not, suspect a problem.
Between 4 and 5 months, healthy babies blink in response to a threat (any silent, sudden movement close to the face which causes no breeze, e.g., opening your fist very suddenly). If not, suspect a problem.
Five to eight months – babies should have depth perception which is the ability to judge if objects are nearer or farther away than other objects. Although an infant’s colour vision is not as sensitive as an adult’s, it is generally believed that babies have good colour vision by five months of age.
By two years of age, a child’s eye-hand coordination and depth perception should be well developed. Children recognize familiar objects and pictures in books and can scribble with crayon or pencil. If not, suspect a problem.
Role of parents
Parents play an important and crucial 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 3 – 6 months of age.
• Helping their child develop his or her vision by engaging in age-appropriate activities.
Vision screening
Your child’s first vision screening may be done by your family doctor, pediatrician, the school nurse, or an eye specialist. Experts have different opinions as to who should do vision screenings and exams for children. Many ophthalmologists and pediatricians feel that vision screening can be part of your child’s routine paediatric check-ups — with referral to an eye care provider if problems are noted.
Detecting eye and vision problems in children
Most of the time, vision problems are not obvious, and the best way to catch issues early is through vision screenings. Sometimes, though, there are symptoms of eye problems such as infection, cataracts, or other issues. Warning signs may include: eye rubbing, redness, puss, swelling, bulging eyes, white, yellow, or gray-white material in the pupil of the eye.
If your child has any of these symptoms, or his/her eyes change in any way, or you are worried about his/her vision, do not wait until he/she is 3 years old to get that first vision test.
Conclusion
It is important to detect any eye or vision problems early to ensure babies have the opportunity to develop the visual abilities they need to grow and learn. All newborns should have their eyes examined from birth and at regular intervals after. Parents play a crucial role in detecting visual and eye disorders in children. If you are concerned about the vision of your child, talk to your healthcare provider as soon as possible. Many disorders if detected and treated at an early stage can be important for the good health and development of your child.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
