How To Know If Your Baby Needs To See An Eye Doctor

The Traveling Parent
9 min readApr 27, 2018

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Originally published at www.thetravelingparent.com.

How To Know If Your Baby Needs To See An Eye Doctor

Does your baby need to be seen by an eye doctor? Click here to learn about signs that you should make an appointment.

You know when your child is happy, sleepy, tired, or grumpy, but do you know when it’s time to start taking them to an eye doctor?

Vision problems can cause huge issues down the line for your child — including interfering with school and work. However, there is good news: many vision problems and injuries are preventable with good care and regular visits to the eye doctor.

You may think that the eye exam your baby received at birth was enough to cut it for another few years, but you’ll need to take follow-up steps in order to truly guarantee proper eye development.

Timeline of Healthy Eye Development

When your baby is born, its eyesight isn’t fully developed. Your little one’s vision goes through significant changes throughout the first year of their life.

Here’s an outline of healthy eye development so you can compare your child’s progress.

Birth

Babies are dealing with all sorts of new stimulation when they’re born. They will likely look at certain things — particularly if they are lit in high-contrast — but they won’t be able to differentiate between different visual targets or switch between two objects.

Babies can mostly focus on objects that are 8 to 10 inches from their face, AKA the distance to your face when you’re holding them close.

One to Four Months

Pretty early on, your baby’s eyes begin working together. Their vision will improve quickly and they’ll have an easier time focusing their vision on your face.

That being said, their eyes are not super well-coordinated in the first two months. They might drift or cross. In most cases, this is normal — but if one of their eyes always looks a little off, you’ll want to consult with an eye doctor.

During this stage, they’ll begin to grow their hand-eye coordination by seeing things and then trying to grab them. (Lots of eyeglasses and necklaces with tiny, smudged fingerprints on them starting at three months.)

Five to Eight Months

This is when depth perception comes in. Depth perception is the ability to tell where an object is in space. That means your baby is starting to see in three-dimensions and can judge distances.

In addition to viewing depth, your baby should be able to see color pretty well during this stage. While it’s not as advanced as yours, your baby’s color vision should be thoroughly developed by five months.

Crawling typically begins around 8 months, which means more opportunities to practice hand-eye coordination.

If you’re worried about your baby taking too long to walk, fear not! It turns out that early walkers who skipped this step might not use their eyes together as well as a baby who spent more time on all-fours.

Nine to Twelve Months

The fun begins! Lots of crawling and standing in this stage means great things for your baby’s ability to use their eyes together.

They’re starting to grasp objects and can now throw things with a more accurate aim (time to move your knick-knacks off of the coffee table).

In the next year, your baby will begin thoroughly exploring their environment. They want to look, listen, and touch to better understand what’s going on around them. They will recognize objects around them and remember the images in their favorite picture books.

This stage is when drawing and scribbling begins, so keep an eye on those walls!

Encouraging Healthy Eye Development

There are lots of ways you can encourage healthy eye development as your baby grows. I’ve included some simple steps you can take with each age below.

0 to 4 months:

  • Keep toys appropriate to your baby’s age within 8 to 12 inches of your little one.
  • Put a nightlight in your baby’s room.
  • Change your baby’s position within their crib and consider moving the crib around the room

5 to 8 months:

  • Give your baby blocks made of wood or plastic they can hold.
  • Hang a mobile above the baby’s crib.
  • Let your baby spend lots of time playing on the floor.

9 to 12 months:

  • Encourage your child to crawl.
  • Play peek-a-boo and hide-and-seek games so that your baby develops visual memory.

How Often Should Your Child See an Eye Doctor?

So now you know how your baby’s eyes should develop, but when does the eye doctor come into play?

Your baby’s primary doctor should be examining their eyes at every visit their first year. Does your baby have a family history of eye tumors, cataracts, or other genetic diseases? Are they premature? If any of these are true, a specialist should be consulted while they’re still at the hospital.

At six months old, your baby’s doctor will check to make sure their eyes are straight, focusing, and to make sure they don’t have any internal eye diseases.

The idea is to catch any abnormalities early on so that you can begin treatment while the eyes are in development.

During the first year, your baby’s regular pediatrician can conduct their eye exams.

If there appears to be an issue, you should consult an eye doctor who specializes in infant exams.

Common Eye Conditions

As a parent, you are the authority on your baby’s health. You see them every day and know what’s normal and what’s not. Because your baby’s eyes are developing so much at the beginning of their life, it might be tricky to know what’s a real problem.

Here are some common problems that may come up. If any of these symptoms occur, you’ll need to take your little one to see an eye doctor.

Strabismus

A child with strabismus will have eyes that point in different directions. The misalignment could happen always or just occasionally, but either way, you should see an eye doctor.

There are three common types of strabismus:

  • Esotropia — Esotropia is a kind of strabismus where the eyes turn in towards each other, sometimes referred to as “crossed eyes.”
  • Exotropia — Exotropia describes when the eyes turn outward, sometimes called being “wall-eyed.”
  • Hypertropia or Hypotropia — These terms describe when the eyes are uneven. The abnormal eye will be higher or lower than the normal eye.

Common Causes:

Often, strabismus happens when there are problems with the muscles and nerves that control eye movement. Sometimes this can be due to an issue in the brain.

This condition can also be your child’s way of making up for farsightedness. It can occur when your child is still an infant.

Treatment:

If your baby has strabismus, an eye doctor can help you choose the best course of treatment for them. Often, this process involves some combination of glasses, exercises, and sometimes eye muscle surgery.

Nystagmus

Your baby may have nystagmus if their eyes make repetitive, jerky movements. It may appear that their eyes are shaky.

The movements may come in a variety of patterns, including up and down, side to side, or circular. This condition can negatively affect your child’s ability to see objects steadily and may impact their coordination and balance.

Nystagmus is often a symptom of another eye condition, but researchers haven’t pinpointed the exact cause.

There are three forms of nystagmus:

  • Infantile — This form of nystagmus typically develops by the time your baby is two or three months old. It may develop in conjunction with other conditions such as albinism or cataracts.
  • Spasmus nutans — This form of nystagmus usually starts between 6 months and 3 years of age and can get better by itself over time (typically at 2 to 8 years old). Little ones with this kind of nystagmus will often tilt their heads or nod. While this kind of nystagmus does not often need treatment, you should consult with an eye doctor to be sure.
  • Acquired — This form of nystagmus doesn’t begin to develop until late childhood or adulthood. While it may be rooted in problems with the central nervous system, the cause is often unknown.

Common causes:

The first two kinds of nystagmus are often caused by neurological problems that your baby was born with. Sometimes, though, the condition can be triggered by problems with eye movement development, cataracts, or other issues.

Treatment:

Your child’s eye doctor will help you plan a course of treatment. Treatment strategies may include glasses or corrective lenses.

Because nystagmus can sometimes improve as your child grows up, surgery is rarely used. In some cases, surgery can help lessen the impact of the condition if it doesn’t improve over time.

Ptosis

Ptosis is a condition that happens when your child’s upper eyelid droops down over their eye. Depending on the severity of the case, ptosis can negatively impact your child’s vision.

Congenital ptosis happens when your baby is born with ptosis. Usually, this is caused by the levator muscle. This is the muscle that moves the eyelid up and down.

There are a few signs you can use to recognize potential ptosis in your baby. It’s most obvious when your baby’s eyelid is drooping. You may also notice that the creases of their eyelids don’t match up. As your child gets older, you might see them raising their eyebrows, or tipping their heads back.

Treatment:

Ptosis should be treated as soon as possible to avoid complications like a lazy eye (or amblyopia), blocked vision, or even astigmatism.

An eye doctor will decide the best treatment for your child, but they often will recommend surgery to fix the muscles that raise the eyelid.

Eye Injury

There are many common eye injuries that may affect your baby. Some of the most frequent include:

  • Corneal abrasion — This happens when something scratches the surface of your child’s eye. Common symptoms include eye redness and light-sensitivity. These scratches may make your child more susceptible to certain infections.
  • Foreign substance in eye — This happens when any kind of substance other than water gets in your child’s eye. Often, this occurs when a splash of something like a cleaner or hygiene product gets in the eye.
  • Eye swelling — This happens when something strikes your baby’s eye. A thrown toy or a misplaced fall can cause swelling around the eye. In older children, treatment with an ice pack should suffice. With babies, however, you may want to consult their eye doctor or pediatrician for treatment.

There are other, more extreme eye injuries that can occur. But with all of these problems, you should consult your baby’s doctor or go to the ER immediately.

Other Signs You Should Take Your Baby to an Eye Doctor

These specific issues aren’t the only signs that you need to get your baby to an eye doctor.

Other worrying symptoms include:

  • Red, crusty eyelids — a common symptom of eye infections
  • Excessive amount of tears — could be a symptom of blocked or clogged tear ducts
  • Strong light sensitivity — sometimes indicates pressure in the eye
  • The pupil appears white — may be a symptom of an eye cancer
  • Frequent or constant turning of the eyes — a potential indicator of a problem with the eye muscles
  • Choosing the Right Eye Doctor

Picking out an eye doctor for your baby may feel like an overwhelming task. After all, you want what’s best for your child’s eye health — and a good doctor can make the whole process a lot easier.

While your baby’s pediatrician may conduct thorough enough eye exams during your baby’s first visits, you might want to get started with an eye doctor right away — particularly if you have concerns.

It might seem logical to take your baby to your own optometrist, but not all eye doctors specialize in examining children. Check out The Traveling Parent to find a doctor that specializes in children’s eye health.

You may also ask family, friends, or your baby’s pediatrician for a referral.

Next Steps

Keeping your baby healthy is key to helping them avoid difficulties in all aspects of their lives.

Knowing when to take your little one to the eye doctor and finding a good one in your area is only one of many steps you need to take after your baby is born. As always, knowledge is power. Do your research and read our blogs about how to prep for your child’s first dentist appointment, or how to find a daycare that meets you can trust, or even the pros and cons of public preschool.

Because it takes a village to raise a happy, healthy child, The Traveling Parent can help you start building your team today.

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The Traveling Parent

The Traveling Parent is a local guide for a parent’s day to day needs.