Key points to remember

seek medical advice if you have any concerns about your child’s eyes

Introduction

Light enters the eye through the cornea, the clear outer skin or window at the front of the eye. It passes through the pupil, the hole in the iris or coloured part of the eye. Light rays are then focused on the retina at the back of the eye. Information about the light travels from the retina to the brain where the pictures are recognised and interpreted.

See the checklist below for some of the things you can look for in your baby’s first year.

At birth

are attracted to faces
may avoid bright lights by closing eyes
may sometimes appear to wander or be turned

At one month

start to fix on mother's face whilst feeding
intermittent turn in eyes
follow large moving objects for a few seconds and begin to show interest in toys

At two months

more interested in toys and objects
follow a person with their eyes
recognise parent’s face and can tell it from other faces

At four months

can focus on toys held close to them
eyes should be straight and move together in all directions
interested in smaller more detailed toys
reaches for toys, grasps firmly and regards closely

At six months

become more skilled in using their eyes to locate and reach objects of interest
follow objects with head and eyes in all directions
visually alert and curious about their surroundings
follows an adult’s movement across the room

At twelve months

recognise familiar people from at least six metres (20 feet) away
binocular vision established at nine months
if you have any questions about your child’s development, see your doctor or Well Child provider

Common eye problems in children

Strabismus

Strabismus may be known as turned eyes, cross eyes, walleyes, squint, or lazy eyes. Strabismus occurs when the eyes point in different directions. When one eye is straight the other may point in, out, up or down. This may be noticeable all the time, or it may come and go. It may be present at birth or appear later. In babies and children with strabismus, the vision in the turned eye will not develop normally. Children do not outgrow strabismus. Treatment is most effective when commenced at an early age. Treatment is carried out by an ophthalmologist (eye specialist) and orthoptist.

The aims of strabismus treatment are:

good vision in both eyes
good appearance
coordinated eyes (that is, depth perception)

Treatment of strabismus may include glasses, patching, exercises, or surgery and is usually a combination of these.

Amblyopia

Amblyopia occurs when one eye becomes lazy because it is not receiving as clear a picture as its fellow eye. The most common causes of amblyopia are strabismus, refractive error (incorrect focusing power), ptosis (droopy eyelid) and cataract (opacity in the lens). Vision can be improved in many cases of amblyopia when treatment is undertaken at an early age.

Epiphora

Epiphora or watering eyes may occur if the duct that drains tears from the eye to the nose becomes blocked. In many cases, blocked tear ducts get better by themselves, but if this doesn’t happen within 12 months, treatment in the form of a minor surgical procedure may be necessary. Blocked tear ducts are not the only cause of watering eyes so an eye examination is suggested.

Remember: occasionally, serious conditions can have signs and symptoms similar to those described above. For this reason children with suspected eye problems should be examined.

Signs to watch for

Consult your family doctor if you are concerned about your baby’s eyes, particularly if:

one or both pupils have an unusual or white appearance. This may be noticed in photographs
there is persistent watering or discharge from the eyes
one eye appears to be turned frequently or the eyes do not seem to move well
there is extreme sensitivity to light or glare
the head is consistently tilted / turned to one side
the child sits close to the television and holds books / puzzles at very close range
the eyes do not look the same

Routine screening

A full eye test is recommended for all infants and children when there is:

turned eye (strabismus) or a family history of turned eye
lazy eye (amblyopia) or a family history of lazy eye
strong glasses at an early age (refractive error) or a family history of strong glasses at an early age
premature birth (36 weeks gestation or less)
developmental delay

Where to go for more information

On this website

Activities in under fives - eyes need to move too - ideas for newborns and infants

Conjunctivitis

Acknowledgements

Starship Foundation and the Paediatric Society of New Zealand acknowledge the co-operation of The Children's Hospital at Westmead, Sydney Children's Hospital at Randwick, and Kaleidoscope - Hunter Children's Health Network in making this fact sheet available to patients and families.

Your notes

Endorsement

This fact sheet was endorsed by PSNZ - 07/03/2006

Copyright

Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012

The Paediatric Society of New Zealand
http://www.paediatrics.org.nz

Starship Foundation
http://www.starship.org.nz

The Paediatric Society of New Zealand
http://www.paediatrics.org.nz

Starship Foundation
http://www.starship.org.nz

This fact sheet was printed on: 10-Feb-2012 03:53am

Eyes: Your baby's eyes