Infant Vision Development - An Overview

Introduction:

With age, babies learn to move their eyes together and focus precisely. They also learn to coordinate the information sent to the brain from the eyes to explore the outside world and interact accordingly. The development of the eyes is closely linked to the brain’s development. As the brain matures, so do the eyes of infants. Babies have a visual acuity of 20/400 at birth and progress quickly to an adult level of 20/20 by three to five years of age.

When Should Babies Have Their First Eye Examination?

A routine eye examination is done immediately after birth by a pediatrician (child specialist). Though the baby’s eyesight can be normal, it is recommended that parents have a consultation with an ophthalmologist (eye doctor) when the baby is six months old. The doctor will examine the normal eye movements, and alignment, and check for conditions like nearsightedness (a condition in which nearby objects appear clearer than far-off objects), farsightedness (a condition in which far-off objects appear clearer than nearby objects), or astigmatism (a condition in which the curvature of the eye’s cornea or lens is imperfect).

What Are the Signs of Problems in the Eyes and Vision of Babies?

Eye and vision problems in infants are uncommon. The eyes and vision begin to develop normally with age but parents need to be aware of the following signs to capture eye and vision problems at the earliest.

• Red eyes or the formation of a hard layer on the eyelids.

• Frequent turning of the eyes may indicate an issue with the control of eye muscles.

• Elevated pressure in the eye can cause extreme sensitivity to light.

• White pupils (a round portion of the eye that is usually black) may denote eye cancer.

• Blocked tear ducts can manifest as excessive tearing.

• Watery eyes with tears rolling down the cheeks even if the baby is not crying.

• Drooping of one or both the eyelids and covering the colored portion of the eye called the iris.

• Cloudiness in one or both eyes.

• One pupil looks larger than the other.

• Eyes appear to shake, dance, bounce, or wobble.

How Does the Baby React to Eye and Vision Problems?

Babies react to eye and vision problems in the following ways:

• Rub their eyes often.

• Tend to cover or close one eye when looking at toys.

• Tilts the head to one side or pushes the head towards the front or back to have a clear view of the objects.

• Frequent blinking of eyes.

• Frequent squinting to see the objects clearly.

• Bumps into objects repeatedly.

• Holds the toys close to the eyes.

• Avoids looking at people or objects that are close enough (between 20.32 to 38.1 cm or within 8 to 15 inches).

Which Children Are More Prone to Have Vision Problems?

The following medical history of the child should be kept in mind before diagnosing vision problems in children:

• Premature baby (babies born less than 32 weeks of gestation).

• Family history of vision problems which started at a young age.

• Older kids who had a history of eye injury that could affect vision later.

• Other health conditions.

What Are the Different Stages of Vision Development in Babies?

Babies' eyes are about 65 % the size of adults’ eyes. The different stages of vision development in babies are as follows:

• Week 1: During the first week, babies can see objects that are 8 to 12 inches in front of them which is approximately the distance between the baby and the mother while feeding. Babies usually look fixed only for a few seconds. The baby’s vision at this stage can be made strong by feeding on alternate sides which will stimulate the vision. Parents can get close to the baby’s face while talking. Immediately after birth, babies can see only black and white with shades of grey. Recognition of color develops by four months. The baby’s vision can be stimulated by using toys that are black and white or those with primary colors such as blue, red, or yellow.

• Week 2: By the second week, babies begin to recognize the face of their parents or caregiver and stare into their faces for a few seconds when they smile or talk with them. Parents or caregivers must ensure to stay within their field of vision which is still 8 to 12 inches. This can develop a bond with the baby.

• Week 3: In the third week, the field of vision remains the same but the babies can extend the time of their gaze from a few seconds to about 10 seconds. Though not much noticeable, the baby’s eyes keep changing rapidly. Parents can stimulate the vision by talking with them closely or by showing bold-colored toys.

• Week 4: During the fourth week, babies tend to look sideways by turning their heads rather than shifting their eyes. They turn their eyes sideways by two to four months. Bright colors and large objects gain the baby’s attention. Newborns can be expected to have poor eye coordination and being cross-eyed is normal during this period.

• Two to Three Months: In this stage, babies begin to notice their hands as their eye and hand coordination develops and develop eye contact with the parents or the caretaker. Their eyes begin to follow moving objects, persons, and lights with equal coordination in both eyes. The babies must smile back at their parents during this stage. A pediatrician (child specialist) should be consulted if the baby’s eyes move towards or away from the nose frequently. Also, a consultation with the pediatrician should be made if the baby is unable to focus and follow the objects at this stage.

• Three to Four Months: The babies who are three to four months old, begin to observe the movements of their hands, reach for objects or someone’s face, hold objects in their hands, and try to bring them to their mouth and move their eyes towards various objects or persons. They can also see objects at a long distance and look interestedly at objects that hang above their crib or look at the lip movements of those who talk, sing or read to them.

• Five to Eight Months: By the 5th month, their ability to look at far-off objects has developed completely (depth perception), and can see the world three-dimensionally. They have improved color vision but are not as developed as adults and try to grab objects located near and far. They can recognize the parent’s or the caretaker’s face, smile at them, see things outside the window and remember certain objects even if they see a part of them. Babies begin to crawl by 8 months of age and this further enhances eye and hand coordination.

Hand and eye coordination can be improved by playing simple games like rolling a ball or playing peek-a-boo. Visual memory can be improved by hiding a toy and revealing it to them later. They try to pick up toys that fall down and since their neck control develops at this stage, they tend to turn their eyes to look at objects instead of turning their entire head. Babies are also able to identify themselves in the mirror.

• Nine to Twelve Months: It can be noticed that the baby’s eye color becomes dark as the eye color develops fully by 9 months of age. Very rarely, it can continue to change later. Babies can stand up on their own and can judge the distance. By 10 months of age, the grasping ability of the babies improves and they try to hold the objects using their thumb and forefinger. They can look at fast-moving objects. Since they can recognize pictures at this stage, they can be taught the names of various objects.

Babies learn and try to walk by 12 months of age. Parents should encourage crawling before walking to improve eye and hand coordination.

• 12 to 14 Months: They become interested in various pictures and place shapes in the appropriate holes. Infants at this stage recognize familiar faces and pictures and gesture for various objects.

• 18 to 24 Months: The babies during this period grasp things that are taught to them and point to their eyes, nose, and other body parts when asked. They can focus clearly on near and distant objects and get engaged in scribbling with crayons or pencils.

• 36 to 38 Months: The infants learn to copy shapes and their visual acuity approaches 20/20. They can recognize and remember the name of colors.

• 48 to 72 Months: The ability to focus on near and distant objects has completely developed and they begin to read, recognize and recite the alphabet when taught.

What Vision Problems Develop in Toddlers?

A condition called amblyopia or lazy eye can develop in toddlers. In this condition, one eye is weaker than the other and the brain tends to favor one eye over the other worsening the weaker eye in due course. Treatment should be initiated as early as possible as it can affect the vision.

How Can Parents Help to Strengthen the Vision in Babies?

Parents can help the babies to strengthen their vision in the following ways:

• Birth to Four Months: The room of the baby should be dim and nightlamps can be used. The position of the crib can be changed frequently along with the position of the baby. Toys can be kept within the field of vision that is between 8 to 12 inches. Alternating the sides while feeding and talking close to the baby can be followed.

• Five to Eight Months: Hanging colorful, attractive objects above the crib to enable the baby to grab, pull and kick the objects can be installed. Plastic or wooden blocks that can be held by the baby can be given and sufficient time must be provided to encourage them to play and explore the things around them. Simple games that can improve eye and hand coordination should be introduced. Promoting tummy times helps the babies to explore their surroundings. Placing the babies in front of the mirror can improve their vision as they observe various movements of them.

• Nine to Twelve Months: The baby must be allowed to crawl and games such as peek-a-boo or hiding the objects and revealing them to them can be done to improve visual memory. The name of the objects should be mentioned while showing them to the babies to enhance their vocabulary and word association skills.

• One to Two Years: Giving objects of various sized to improve their small muscles and fine motor skills should be followed. Reading or telling stories to infants can help them visualize and improve their reading and learning abilities. Games such as rolling the ball toward them and asking them to do the same can be practiced.

Conclusion:

One of the most important senses among the five senses is the sense of vision as this enables the child to learn and explore the world around them. Baby’s vision develops gradually during their first year and parents can help them improve their vision by following the simple measures mentioned above. Since prevention is better than cure, regular eye checkups should be undertaken and minor signs should not be ignored by the parents or caretakers.