At Birth
At birth, a baby blinks in response to light. A new-born baby may focus on a stationary object fairly well, but would likely not follow it if it moves. It is easier for a new-born baby to see something next to them using peripheral vision, as their central vision is not yet fully developed.[1] The nerve cells in the retina are not yet fully developed and their visual acuity is about 20/400 at birth. By week one, a baby can see red, orange, yellow and green; and later blue and violet. In the following few weeks, their ability to identify lines, patterns, movement and colours develop. [1]
At birth: Visual acuity is approximately 20/400 at birth.
At One Month
At around six weeks old, a baby now starts showing interest in faces and patterned or high contrast objects and will focus on people or objects up to about 30 cm away. The baby now starts to make meaningful eye contact, looks at faces intentionally and will hold a gaze with their eyes wide open. [1] You may notice that your baby enjoys watching your face while feeding and is starting to smile in response to faces, as smiling is a visually learnt behaviour. Your baby would now no longer be as sensitive to light and would now show preference to familiar faces.
Between Two to Four Months
Between two to four months, a baby’s eyes now work together and their ability to focus on and track objects improves. Your baby will also start to shift their gaze from one object to another without having to move their head. At this stage, hand-eye coordination starts to develop and your baby may start swiping at a moving object. A baby on their tummy will now lift their head and chest to get a better view of faces and objects, roll towards objects and eventually start pushing up on their arms and rotate on their tummy. [2] During the first two months, a baby’s eyes do not necessarily work well together. You may, therefore, find that they appear to be cross-eyed or their eyes may occasionally seem to wander to the sides. This will usually self-correct within the next two to four months. If this continues to occur, it is advisable to consult with your doctor or an eye specialist. [2]
Two to four months: Visual acuity improves.
Between Five to Eight Months
At this age, a baby starts to see the world in 3-dimensions and depth perception improves. They now start reaching for objects both near and far away. At 6 months old, a baby now demonstrates visual attention. [1] Your baby will now start to look for you across the room and smile. As their understanding of objects improves, they may also start to recognize an object that is partly hidden. [2] They will now start showing interest in pictures and may pat pictures in a book. A baby now starts to seek out objects that are visually interesting and starts to develop gross motor skills such as creeping on their tummy and eventually crawling.
Between five to eight months: Colour vision has improved, but has not yet fully developed. Visual acuity is about 20/25 at six months old.
Between Nine To 12 Months
Accuracy of reaching for, grasping and throwing objects now becomes more refined. As your baby develops a better awareness of their body, they also learn to coordinate vision with their body movements. Their ability to judge distance improves and they start attempting picking up smaller objects using their thumb and index finger. [2] They are now also showing interest in standing up, moving with furniture and learning to walk. A baby at this age starts to point to objects to request, will point at a picture when named, learns to wave responsively and will look to you for guidance in unfamiliar or new activities or situations.
By 1 year, most babies can now attend to an object at a 20-foot distance.
Why Does My Child’s Therapy Team Focus on Vision?
Vision plays an important role in the development of gross motor, fine motor, perceptual, cognitive, social and communication skills. It influences a baby’s motivation to engage with the world and develop the necessary skills to function optimally in daily life. The visual system, being a major sensory system, may also impact on all other areas of sensory modulation. For example, a baby with visual difficulties may be startled by textures that are suddenly introduced as they cannot be anticipated by visual recognition, or may dislike sudden movement as they feel insecure. Vision is, therefore, an important motivator to encourage participation and promote optimal development. Adaptations and compensatory strategies may also be used by your child’s therapist should there be visual difficulties present.
What Should I Look Out for If I Am Worried About My Child’s Vision? [1]
- Poor eye contact with people.
- Difficulty focusing or following a face or toys.
- Delayed onset of a social smile.
- Nystagmus (may develop between one to four months of age).
- Light sensitivity.
- Staring at lights.
- Pressing on the eyes excessively.
- Holding objects very close to the eyes.
- Poor attention to distant objects.
Who Should I Consult with If I Am Worried About My Child’s Vision?
It is important to discuss your concerns with your child’s treating doctor. Should formal vision testing be required consultation with an ophthalmologist and a behavioural optometrist may be advised. In the case of a visual difficulty being identified, speak to your specialist about treatment options and available therapies in your area.
References
- Edmond JC. Why Can’t My Baby See? American Academy of Ophthalmology. April 2014.32(4):1-15.
- Baby’s Vision Development: What to Expect the First Year. [Internet]. American Academy of Ophthalmology. [Updated 2017 May 22; Cited 2020 January 16]. Available from: https://www.aao.org/eye-health/tips-prevention/baby-vision-development-first-year
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