Your Child's Eyes

What can my baby see during the first year of life?

A baby's vision develops quickly during the first year of life.

• Newborns can see large shapes and faces, as well as bright colors.

• By 3 to 4 months, most babies can focus on a variety of smaller objects and tell the difference between colors (especially red and green).

• By 4 months, a baby's eyes should be working together. This is when babies begin to develop depth perception (binocular vision).

• By 12 months, a child's vision reaches normal adult levels while he continues to learn about and understand what he sees.

Keep in mind that each child's vision develops at his or her own rate, but the overall pattern of development is the same. Because a baby's vision develops quickly during the first year of life, your child's doctor will check your baby's eyes at each well-child visit. Even after the first year, regular eye exams by your child's doctor are important to identify problems that may arise later in childhood.

What are warning signs of a vision problem?

• Babies up to 1 year of age. Babies older than 3 months should be able to follow or track an object, like a toy or ball, with their eyes as it moves across their field of vision. If your baby can't make steady eye contact by this time or seems unable to see, let your child's doctor know.

  Before 4 months, most babies' eyes occasionally look misaligned (strabismus). However, after 4 months, inward crossing or outward drifting that occurs regularly is usually abnormal. If one of these is present, let your child's doctor know.

• Preschool age. If your child's eyes become misaligned, let your child's doctor know right away. However, vision problems such as a lazy eye (amblyopia) may have no warning signs, and your child may not report vision problems. That is why it's important at this time to have your child's vision checked. There are special tests to check your child's vision even if he cannot yet read.

• All children. If you notice any of the following signs or symptoms, let your child's doctor know:

  • Eyes that are misaligned (look crossed, turn out, or don't focus together)

  • White or grayish white color in the pupil

  • Eyes that flutter quickly from side to side or up and down

  • Eye pain, itchiness, or discomfort reported by your child.

  • Redness in either eye that doesn't go away in a few days

  • Pus or crust in either eye

  • Eyes that are always watery

  • Drooping eyelids

  • Eyes that often appear overly sensitive to light

When should my child's eyes be checked?

Vision screening is a very important way to identify vision problems. During an exam, the doctor looks for eye disease and checks to see if the eyes are working properly. Children with a family history of childhood vision problems are more likely to have eye problems.

The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that children have their eyes checked by a pediatrician at the following ages:

• Newborn. All babies should have their eyes checked for infections, defects, cataracts, or glaucoma before leaving the hospital. This is especially true for premature babies, babies who were given oxygen for an extended period, and babies with multiple medical problems.

• By 6 months of age. As part of each well-child visit, eye health, vision development, and alignment of the eyes should be checked.

• Starting at 1 to 2 years. Photo screening devices can be used to start detecting potential eyes problems.

• At 3 to 4 years. Eyes and vision should be checked for any abnormalities that may cause problems with later development.

• At 5 years and older. Vision in each eye should be checked separately every year. If a problem is found during routine eye exams, your child's doctor may have your child see a pediatric ophthalmologist. A pediatric ophthalmologist is an eye doctor trained and experienced in the care of children's eye problems.