Early Years of Development Are Vital

From the moment your child is born, they start using their eyes.

“The early years of life are vital to the vision development of children,” says Northwestern Medicine Pediatric Ophthalmologist Bahram Rahmani, MD. “If anything during that period interferes with vision, it can potentially have a permanent impact.”

Vision Development

During the first few months of life, your child’s vision evolves from blurred outlines to the eyes working together to focus on objects about 8 to 10 inches away — usually their parents’ faces.

“This is a critical time,” says Dr. Rahmani. “If a child is born with congenital cataracts or any other abnormality in the eye that is blocking the vision or preventing the eye from opening, we must address it immediately to prevent long-term vision damage.”

Dr. Rahmani also says droopy eyelids are something else to look for, as they can lead to a condition called amblyopia, or lazy eye. Amblyopia is the most common cause of visual impairment among children. Amblyopia can occur for a variety of reasons, but results in the eyes not being able to focus properly or work together. A common form of amblyopia is typically treated early with glasses that help focus the eyes.

Babies also begin following moving objects with their eyes and reaching for them at about 3 months of age. Around 5 to 8 months, eye control and coordination improve, and depth perception and color vision develop. By age 6, your child’s vision has fully developed.

Make Sure Your Child Is Tracking

“As a parent, you can observe your child the closest to ensure that they are focusing their vision and paying attention to their surroundings,” says Dr. Rahmani. “If your child is not meeting developmental milestones for vision during their first year, or if there is another indication that your child can’t see well, consult your pediatrician.”

The following abnormal behaviors can indicate your child has vision problems.

Infant to 3 years old:

• Your child doesn’t reach for things properly.
• Your child doesn’t seem to notice movements or changes in light.
• Your child is unusually sensitive to light.
• Your child’s eye wanders around.

Ages 3 to 5 ― the above behaviors and:

• Sitting close to the TV, or holding a book or toy too close.
• Squinting or head tilting.
• Difficulty with tasks requiring eye-hand-body coordination.
• Avoidance of detailed activities involving small pieces or colors.
• Short attention span.

Ages 6 to 18 ― the above behaviors and:

• Avoiding reading and other visual tasks, or a low comprehension of these tasks.
• Complaining of tired eyes or headaches.

Also keep an eye out for these abnormalities:

• Eyes crossing, turning out or not moving together.
• Droopy eyelids.
• Dullness in the eyes.
• Difference in pupil sizes.
• Redness, crustiness, discolored tears or discharge from the eye.

Dr. Rahmani recommends testing the red reflex of your child’s eyes with flash photography on your smartphone.

“Take a picture of your child straight on with the flash to make sure that the reflection in the center of the eye is the same on both sides,” says Dr. Rahmani. The picture should show equal amounts of light reflecting back to the camera from each eye. “This is an easy screening method you can do at home to make sure that the eyes are aligned and reflecting the same amount of light.”

Dr. Rahmani says you can also monitor the exterior of your child’s eyes with smartphone photos. “Save some pictures of your child so that you have a catalog to reference if you need to show a physician and don’t delete the ‘bad’ photos if your child develops an eye condition,” he explains.

Eye Exam Schedule

The American Association of Ophthalmology and the American Academy of Pediatrics (AAP) recommend that children receive an eye examination around age 3 for the first time if they have no other signs of vision problems. Your pediatrician will typically test your child’s vision in their annual examination to determine if you need to see a pediatric ophthalmologist. According to the AAP, regular vision screening is required within most school districts for children between ages 3 and 6, and again at ages 8, 10, 12 and 15. Locally, the Illinois Department of Public Health requires vision screenings for preschool, kindergarten, second grade and eighth grade.

Vision problems tend to run in the family. If you have an older child with vision problems, it’s a good idea to have the younger child screened earlier than the recommended 3 years of age.

“Early detection and quick intervention can really make a difference,” says Dr. Rahmani. “Vision is a critical way for children to take in the world. It impacts the psychology and mental well-being of a child, which is why it’s so important to address as soon as possible.”