Everything you need to know about your baby’s vision
A newborn’s vision takes time to develop
The first time a baby opens their eyes and makes eye contact is one of the greatest moments a new parent can experience. But don’t be concerned if that moment doesn’t happen right away.
A baby’s vision will take some time to develop. In the first week of life, babies don’t see much detail. Their first view of the world is indistinct and only in shades of gray.
It takes several months for your newborn’s eyesight to develop fully. Knowing the milestones of your baby’s vision development — and what you can do to help it along — ensures your child is seeing properly and enjoying their world to the fullest as soon as possible.
Baby vision development starts during pregnancy
Your baby’s vision starts to develop before they’re even born.
How you care for your own body during your pregnancy is extremely important for the development of your baby’s body and mind, including the eyes and the vision centers in the brain.
Be sure to follow the instructions your OB-GYN gives you regarding proper nutrition, including supplements, and get the proper amount of rest you need during your pregnancy.
Avoid smoking and consuming alcohol or drugs during pregnancy, as these toxins can cause multiple problems for your baby, including serious eyesight problems.
Smoking is particularly hazardous during pregnancy, as cigarette smoke contains an estimated 3,000 different chemicals that can potentially harm humans — including carbon monoxide, a known fetal toxin.
Even taking common medications like aspirin can be dangerous to your baby when you are pregnant, increasing the risk of low birth weight and problems during delivery. Low birth weight has been associated with an increased risk of vision problems in infants.
Always talk to your OB-GYN before taking any medications during your pregnancy, including over-the-counter medicines, herbal supplements and other non-prescription remedies.
SEE RELATED: How pregnancy can affect your vision
Newborn vision at birth
Soon after birth, your doctor will briefly examine your infant’s eyes to rule out signs of congenital cataracts or other serious neonatal eye problems. Though such eye problems are rare, they must be detected and treated early to minimize their impact on your child’s vision development.
An antibiotic ointment is usually applied to your newborn’s eyes to help prevent an eye infection from bacteria present in the birth canal.
At birth, your baby only sees in black, white and shades of gray, since the nerve cells that control vision in the retina and brain aren’t fully developed.
At this stage, a newborn’s eyes can’t focus on near objects. Don’t be concerned if your baby doesn’t seem to be “focusing” on objects, including your face. It just takes time.
Despite these visual limitations, studies show that, within a few days after birth, infants prefer looking at an image of their mother’s face to that of a stranger. [Read more about the importance of eye contact for child development.]
Researchers believe this preference depends on large, high-contrast stimuli, like the boundary of the mother’s hairline to her face. In studies, if these boundaries were masked with a scarf or bathing cap, the infants’ preference of looking at their mother’s face went away.
To encourage visual interaction with your newborn child, try to keep your hairstyle the same and avoid altering your appearance.
One thing you may notice about your newborn son or daughter is how large their eyes are. This is because normal infant development proceeds from the head down.
At birth, your baby’s eyes are already 65% of their adult size!
SEE RELATED: What nursery colors are best for a baby's vision?
Your baby’s eyes: The first month
Your baby’s eyes are not very sensitive to light in the first month after birth.
In fact, the amount of light required for a 1-month-old infant to be aware that light is present is 50 times higher than that of an adult.
That means that it’s okay to leave some lights on in the nursery. It won’t affect their ability to sleep, and it may keep you from stubbing your toe in the dark room.
Infants start to develop the ability to see in colors very quickly. One week after birth they can see red, orange, yellow and green, but it takes a little longer for your infant to be able to see blue and violet.
Don’t be too concerned if your baby’s eyes don’t always appear to be working together as a team early on.
One eye may occasionally drift inward or outward from proper alignment. This is normal, but if you see a large and constant misalignment, notify your eye doctor.
To help stimulate your baby’s eyesight during this period:
Decorate their room with bright, cheerful colors.
Include artwork and furnishings with contrasting colors and shapes.
Try hanging a brightly colored mobile that features a variety of colors and shapes.
Months 2 and 3
Baby vision makes several important advances during months two and three. Infants develop sharper visual acuity during this period, and their eyes begin to move better as a team.
By this point, your baby should be following moving objects with their eyes and reaching for things they see.
Infants at this stage of development are learning how to shift their gaze from one object to another without having to move their head.
Their eyes are now becoming more sensitive to light. At 3 months, an infant’s light detection threshold is only 10 times that of an adult. You may now want to dim the lights a bit more while they’re sleeping.
To help stimulate your 2- to 3-month-old baby’s vision development, the American Optometric Association recommends:
Add new items to their room or frequently change the location of existing items, including their crib.
Talk to your baby as you walk around the room.
Keep a night light on to provide visual stimulation when your child is awake in their crib.
Let your baby crawl. While infants should be placed on their backs for sleep to decrease the risk of sudden infant death syndrome (SIDS), put them on their stomachs when they are awake and you can supervise them. This provides important visual and motor experiences.
Months 4 to 6
By age 6 months, significant advances have taken place in the vision centers of the brain, allowing your infant to see more distinctly and move their eyes more quickly and accurately while they follow moving objects.
Visual acuity improves from about 20/400 at birth to roughly 20/25 at 6 months of age. Color vision should be similar to that of an adult as well, enabling your child to see all the colors of the rainbow.
Babies also have better hand-eye coordination at 4 to 6 months of age, allowing them to quickly locate and pick up objects. That includes accurately directing a bottle — and many other things — toward their mouth.
Six months of age is also an important milestone because it’s when your child should have their first children’s eye exam (unless complications arise before this time).
Even though your baby can’t read the letters on an eye chart, your eye doctor can perform non-verbal testing to assess their visual acuity, detect nearsightedness, farsightedness and astigmatism, and evaluate eye teaming and alignment.
At this exam, your eye care practitioner will also check the health of your baby’s eyes and look for anything that might interfere with normal and continuing vision development.
For the most thorough eye exam for your 6-month-old, you may want to seek the services of an eye doctor who specializes in children’s eyesight and vision development.
SEE RELATED: What should my child expect at their first eye exam?
Months 7 to 12
Your child is now mobile, crawling about and covering more distance than you could ever have imagined. They are better at judging distances and more accurate at grasping and throwing objects.
This is an important developmental period for your child. At this stage, infants are developing a better overall awareness of their body and learning how to coordinate their vision with their movements.
It’s also a time that requires more diligence on your part to keep your baby from harm.
Bumps, bruises, eye injuries and other serious accidents can occur as they start to physically explore their environment. In particular, keep cabinets locked and put barriers in front of stairs.
Don’t be concerned if your infant’s eyes are starting to change color.
Most babies are born with blue eyes because darker pigments in the iris aren’t completely developed at birth. Over time, more dark pigment is produced, which can change your child’s eye color from blue to brown, green, gray or a mixture of colors — as is the case with hazel eyes or heterochromia.
READ NEXT: Vision problems of preschool children
To stimulate the development of your child’s hand-eye coordination:
Get down on the floor with your baby and encourage them to crawl toward objects.
Place a favorite toy on the floor just out of reach and encourage them to get it.
Provide plenty of safe objects and toys that they can take apart and put together.
Eye alignment problems
Be sure to pay close attention to how well your baby’s eyes work together as a team.
Strabismus is the term for a misalignment of the eyes. It’s important to detect and treat it early so your baby’s vision develops properly in both eyes.
Left untreated, strabismus can lead to amblyopia, commonly known as “lazy eye.”
It takes a few months for newborn eyes to develop coordination skills, but don’t hesitate to contact your pediatrician or eye doctor if you feel one of your baby’s eyes is misaligned or doesn’t move in sync with the other eye.
READ NEXT: What Is Hypertelorism?
Premature babies and eyesight problems
The average length of a normal pregnancy is approximately 40 weeks. Babies born before 37 weeks of gestation are considered premature, according to the World Health Organization.
Smoking during pregnancy significantly increases the risk of giving birth prematurely.
Premature babies are at greater risk of eye problems than full-term babies, and the odds increase the earlier the child is born.
Two vision problems are more common in premature babies:
Retinopathy of prematurity (ROP)
ROP is the abnormal replacement of normal tissue in the retina with fibrous tissue and blood vessels. It can cause scarring of the retina, poor vision and retinal detachment. In severe cases, retinopathy of prematurity can lead to blindness.
All premature babies are at risk of ROP. Very low birth weight is an additional risk factor, especially if it is necessary to place the infant in a high-oxygen environment immediately after birth.
If your baby is born prematurely, ask your obstetrician to refer you to a pediatric ophthalmologist so they can perform an internal eye exam and rule out ROP.
Nystagmus is an involuntary, back-and-forth movement of both eyes.
In most cases, nystagmus causes the eyes to drift slowly in one direction and then “jump” back in the other direction. The eye movements are usually horizontal, but they can be diagonal or rotational as well.
The magnitude of the eye movements will usually determine how much the baby’s vision and visual development will be affected.
If your baby shows signs of nystagmus, consult a pediatric ophthalmologist or other eye doctor as soon as possible.
No-cost eye exams for infants
If you can’t afford an eye exam for your baby, help is available.
Developed by the American Optometric Association in partnership with The Vision Care Institute, InfantSEE is a public health program designed to make sure vision care becomes a part of infant wellness routines in the United States.
Under this program, member optometrists offer a no-cost first eye assessment for infants within their first year of life.
To learn more about InfantSEE and to find a participating optometrist, visit the InfantSEE website.
READ MORE: Do your eyes grow?
Page published on Wednesday, February 27, 2019