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Baby’s first eye exam: What to expect

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What should you expect at your baby's first eye exam? A neonatal or infant eye exam involves gentle, expert examination of your baby’s vision and eye health, as well as a few tests to check for infection or any developmental issues. 

New parents are often unsure whether or not their baby needs an eye exam, but an infant eye exam is critical to ensure healthy visual development. In most cases your baby’s eyesight will develop normally, but if there is a problem, catching and treating it early could prevent lifelong issues. 

When should your baby have his or her first eye exam? Your baby’s first eye exam should occur within the first year, possibly sooner depending on your infant’s situation.

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Here are answers to some frequently asked questions about a baby’s first eye exam:

Why should your baby have an eye exam?

A baby’s visual development is most dramatic between the first six and 12 months, so if your baby has any vision problems, you'll want to find and treat them during that first year. 

The American Optometric Association encourages parents to include a visit to an optometrist as part of your infant’s checkups. 

Of course, if you notice anything unusual, such as a white pupil, red or encrusted eyelids, extreme sensitivity to light, a bulging eye, constant eye turn or excessive tearing, your baby should be seen by an eye doctor immediately. 

How does an eye doctor check a baby’s vision?

An eye doctor or pediatric vision specialist will first evaluate your infant’s medical history to check for any family history of eye disease or other health issues. Then the eye doctor will check your baby’s vision, eye muscles and eye structures. 

To check your baby’s vision, the eye doctor may temporarily dilate your infant’s pupils with drops or mist and use a lighted instrument with a magnifying glass (an ophthalmoscope) to look inside your baby’s eyes. 

This device allows the doctor to assess the overall health of the eyes and detect any early signs of problems such as infection, structural issues, malformed eyelids, cataracts or glaucoma

Your eye doctor or pediatric optometrist also will examine how each eye focuses and whether both eyes are working together. 

However, many babies don’t obtain full binocularity until four to six months of age, so if your baby sees an eye doctor early, lack of full binocularity shouldn’t yet be cause for alarm. 

How are babies examined to tell if they need glasses?

Eye doctors use an instrument to test a baby’s eyes for refractive errors, such as nearsightedness, farsightedness or astigmatism. Most babies are slightly farsighted at birth, but this normally disappears by three to five years of age. 

If there is significant visual impairment, a baby can wear glasses designed to fit small faces. If there are other issues or potential problems, your eye doctor will be able to suggest an appropriate course of treatment. 

SEE RELATED: Retinopathy of prematurity: What it is, how it’s treated

What vision problems in your baby could require further evaluation?

In most cases, an eye doctor examining a baby’s eyes won’t find any vision problems, but conditions that could require further evaluation include:

STRABISMUS: Strabismus is a vision condition in which the eyes aren’t aligned and don't move together. 

NYSTAGMUS: Nystagmus is a vision condition in which the eyes jump or wiggle after a baby’s first three months. 

These conditions or any other signs that a baby’s eyesight hasn’t developed properly may warrant additional testing or monitoring. 

If everything is found to be healthy and developing properly, you will likely be urged to schedule your baby’s eye exams every two years. 

It’s important to remember that a baby’s vision changes as he or she grows, so stay on top of your child's eye exams, especially once your baby reaches school age. 

If a visual impairment isn’t caught once your child starts school, it could affect his or her educational success.

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