Babies demonstrate their visual abilities as they gaze at and follow objects with their eyes to "visually track." Even a newborn baby has vision skills such as glancing briefly at colorful objects. A doctor can detect eye problems by examining the baby's appearance and using special testing equipment. In addition, parents may note possible problems if a baby doesn't develop motor milestones such as reaching for toys at the expected age.
Cataracts and Conjunctivitis
Babies born prematurely or who have a condition such as Down syndrome or a neuromuscular disorder such as cerebral palsy often have vision problems. Newborn babies may have cataracts, meaning that the eye's lens has a cloudy covering. When severe, the pupil appears white. Babies with eye infections such as conjunctivitis, sometimes caught during delivery, demonstrate red, swollen eyes. Doctors should carefully examine the eyes of newborns to detect vision problems, especially when the baby has a disability.
Eye Movement Disorders
Children with conditions such as cerebral palsy that cause abnormal muscle tone may have a problem with eye movement, called "strabismus." One or both eyes may turn inward, outward, upward or downward. Eye movement may appear to be choppy, making it difficult to fixate (gaze) at an object or visually track. Babies with neurological impairment may also experience an abnormal eye movement called "nystagmus" in which the pupil moves in a rapid, jerky fashion.
Decreased Refraction and Visual Field Impairment
Babies typically reach for objects with both hands between 4 and 5 months of age and with one hand by 7 months of age. Delays in these milestones may indicate an eye problem. The baby may have poor refraction (the ability to focus on objects). A doctor can detect acuity by using a machine called a retinoscope to determine a prescription for corrective eyeglasses. If a child seems to pay attention to people or objects only when looking in a certain direction, one should consider visual field impairment. This means that the ability to see certain areas such as the left or right side, central gaze (the area seen when looking straight ahead) or peripheral (side) vision is impaired. These impairments may be treated with special glasses, exercises or compensation techniques.
Detecting Binocular Disorders
As a 1-year-old baby begins to use her hands together to place a ring on a stack or balance one block on top of another, she is using her depth perception. Babies who have binocular (using both eyes together) disorders may appear clumsy and overshoot or undershoot the target. Several treatment options are available, including corrective glasses or surgery. The important thing to remember is that many eye and vision problems can be detected and treated at an early age, avoiding the developmental delays that may accompany vision impairment.
References
- Understanding and Managing Vision Deficits; Mitchell Scheiman; 1997
- Hawaii Early Learning Profile Activity Guide; Setsu Furuno; 1985
