Vision Care for Infants

Vision Care for Infants in Annapolis & Glen Burnie, MD & Washington, DC

The eyes and the entire visual system are vital to our overall development. As we develop, approximately 80% of what we learn comes to us through our visual system. If you are lucky, your baby will be one of the majority of infants who are born with normal, healthy eyes. Having healthy eyes, however, does not guarantee that your baby will be able to use them appropriately and efficiently within their environment. Typical infant development is cyclic, not linear. Infants and toddlers move forward and backward while reorganizing and achieving higher developmental levels.

Did You Know?

• Infants are born with poor color vision and should develop it by the age of six months. Infants respond more to contrast at this early age and enjoy looking at black and white targets with familiar pictures such as a face.
• Infants’ eyes are generally observed to be straight after birth. If you observe an eye turn it is important to have this evaluated as soon as possible. The cause, which is frequently motor or sensory, can be a manifestation of an underlying disease process. Early identification and treatment of such conditions may prevent permanent vision loss.

• Infants can only see about 20/400 after birth (the normal big E on the top of the eye chart)… this improves significantly to 20/40 by the age of 12 months.
• Infants and toddlers are usually quite farsighted. This value decreases as they develop towards neutral findings. Interferences in a child’s motor development can influence development of visual skills and the process of becoming less farsighted.
• Infants learn to see their world through a process by which they look, touch and explore. Simple household items like pots and pans are a gold mine for exploration and learning.
• Visual problems are one of the leading causes of handicapping conditions in children. Most of these conditions can be detected and treated during the infant years.

Important Visual Milestones

• Momentarily following an object with the eyes or head by 5 weeks
• Bringing both hands together by 8 weeks
• Holding and sustaining direct eye contact with you by 3 months
• Turning both eyes together and locating near objects by 4 months
• Rolling over independently by 7 months
• Sitting without support by 8 months
• Creeping and crawling by 9 months

When should your infant have a visual examination?

A ‘well baby’ comprehensive vision evaluation should take place around 6 months of age. Early detection is critical in preventing and treating vision conditions that can have lifelong effects.

An evaluation should be sought sooner if you notice any delays in development, if your infant has an eye that turns outward or inward (lasting more than a few seconds) or if you notice excessive rubbing of the eyes. These can be indicators of abnormal visual development and should be evaluated by an experienced optometrist as soon as possible.

Visual Development Recommendations

Adequate time spent on their tummy is crucial to the development of an infant’s motor skills. This tummy time helps strengthen neck and back muscles which lead to the proper development of the visual system. In particular, it helps develop their focusing system, eye-hand coordination and bilateral integration of arms and legs.

0-3 months of age:

• Hold and feed infants from alternating sides. This encourages adequate visual development of both eyes.
• Playfully move your baby’s arms and legs, at first each part separately and then in various combinations. Raise and lower your baby while you look into each other’s eyes.
• Place infants in their crib facing different directions as well as change the location of the crib so they can see the world from many different viewpoints.
• Allow infants to explore with their hands. This provides many different stimuli, including texture, size, weight and form.

4-6 months of age:

• Allow infants to help hold their bottle and have clean, smooth objects available so they can explore with their mouth. This allows the infant to reinforce learning through the different senses.
• Place a kickable mobile at the end of the bassinet.
• Roll a patterned ball towards your baby while sitting on the floor.
• Play peek-a-boo to develop memory and recall. Tie bells on their booties so they can learn about their body through sound and movement patterns.

9-18 months of age:

• Creep through, around, over and under a family furniture obstacle course. This will help encourage general motor and bilateral development.
• Hold your baby’s hand and encourage jumping off a small step. Try to do it over a very low object.
• Identify objects in large baby books.
• Sort pictures of different family members. Ask your baby to identify which picture is of which family member.
• Stacking and nesting toys; fillable objects and pouring toys; toy xylophone/telephone. These toys will help develop eye-hand coordination.
• Have your baby use a large hammer with large pegs.
• Throwing balls or beanbags into a basket on the floor; try to catch balloons.
• Hide an object and have your baby find it.
• Scramble a stack of Lego blocks and then have your baby pick out only one type of block.

18 months – 3 years of age:

• Wheelbarrow game; jumping on a trampoline.
• Playing with puzzles of geometric shapes, animals and common figures.
• Play with large wooden beads for stringing necklaces.
• Use wind-up toys, finger paints, modeling clay to develop eye-hand coordination.

3-4 years of age:
From this age on, most toys and games stimulate a combination of necessary motor skill development, such as visual tracking, eye-hand coordination and eye teaming.

• Hopping
• Climbing equipment
• Tricycle riding
• Wagons and wheelbarrows
• Blunt scissors
• Crayons, paints
• Blowing bubbles
• Puzzles
• Musical instruments
• Water and sand play
• Lacing toys

What is tested during an infant developmental evaluation?

• Review of developmental patient history
• Visual acuity assessment (20/200 … 20/20 etc.)
• Refractive analysis (farsightedness, nearsightedness, astigmatism)
• Visual motor development
• Eye movements
• Eye focusing
• Eye teaming
• Eye-hand integration
• Assessment of eye health

The InfantSEE program is a national program providing free vision evaluations to infants 6-12 months of age.

​​​​​​​Please call our office at (410) 268-4393 to have your infant evaluated today!