have all the eye structures necessary to see, but they haven’t learned to use
them yet. Infants' vision begins to develop at birth. Babies spend much of their
early weeks and months of life learning how to see--developing such skills as
focusing, teaming their eye movements, recognizing depth, developing eye-hand
coordination, and making spatial judgments. As the child grows, more complex
skills, such as visual perception and visual motor integration, develop to meet
the child’s growing need to understand and interpret his world.
to Four Months
they’re born, babies see in black and white and shades of gray. Because
newborns can only focus eight to twelve inches, most of their vision is blurred.
Babies first start to learn to focus their eyes by looking at faces and then
gradually moving out to bright objects of interest brought near them. Newborns
should be able to momentarily hold their gaze on an object for a few seconds,
but by 8-12 weeks they should start to follow people or moving objects with
their eyes. At first, infants have to move their whole head to move their eyes,
but by 2-4 months they should start to move their eyes independently with much
less head movement. When infants start to follow moving objects with their eyes
they begin to develop tracking and eye teaming skills. Young infants haven't
learned to use their eyes together; they haven't developed enough neuromuscular
control yet to keep their eyes from crossing. This alarms many parents, but by 4
or 5 months babies usually have learned to coordinate their eye movements as a
team and the crossed-eyes should stop. (If you're seeing your infant's eyes
cross after this time, this could indicate a problem, and you should seek the
advice of your family optometrist.) By four months, babies start to reach for
objects, the beginning of eye-hand coordination. Also by four months of
age, babies's visual systems have developed the ability to see in full color,
and they're exposed to an exciting new world!
to Six Months
babies learn to push themselves up, roll over, sit, and scoot, eye-body
coordination develops as they learn to control their own movements in space.
Likewise, four- to six-month-old babies become quite skillful with their
eye-hand coordination, able to direct a bottle into the mouth or grasp at
objects freely. Their hands become their most important tool--they reach for
almost everything they see! This is also the time they start to work
on remembering things they see.
By the fourth or fifth month, babies' brains have finished learning how to fuse
the pictures coming in from both their right and left eyes into a single image
for full binocularity, or "two-eyed" vision with strong depth
perception. Spatial and dimensional awareness continue to improve as baby
learns to aim accurately when reaching for objects of interest. Likewise, they
refine their eye teaming and focusing skills as they learn to look quickly and
accurately between near and far distances.
Normal visual acuities, or a child's sharpness of vision, has usually developed
to 20/20 by the time the child reaches six months.
to Eight Months
babies start crawling during this time, further developing eye-body
coordination. They learn to judge distances and set visual goals, seeing
something and moving to get it. Their sudden freedom allows for many new
experiences and the rapid development of visual perception skills as babies
experience their own bodies in relation to other objects and notice differences
in size, shape, and position. By the sixth month, babies acquire fairly accurate
eye movement control. Some experts warn that early walkers may not learn to use
their eyes together as well as babies who have crawled a lot and teamed their
eyes more when looking at close-up objects.
to Twelve Months
can now judge distances well. Eye/hand/body coordination allows them to grasp
and throw objects fairly accurately. Perception skills such as visual memory and
visual discrimination help babies make sense of their exciting new world. The
integration of their vision and fine motor coordination allows babies to
manipulate smaller objects, and many begin feeding themselves with finger foods.
Once children start walking, they learn to use their eyes to direct and
coordinate their bodies' large muscle groups to guide their whole body
vision continues to develop throughout their preschool years. As toddlers, it is
important for them to continue development of eye/hand/body coordination, eye
teaming, and depth perception. Stacking building blocks, rolling a ball back and
forth, coloring, drawing, cutting, or assembling lock-together toys all help
improve these important skills. Also, reading to young children is also
important. They develop strong visualization skills as they "picture"
the story in their minds.
A child should have
his first eye exam by age three (sooner if vision problems run in the family) so
the optometrist can check if vision is developing normally and catch any
problems early. Vision should be checked again when the child enters school.
is important for children to have a complete eye examination before starting
school. The optometrist needs to determine if a child’s vision system is
adequately prepared to handle reading, writing and other close work. The demands
of schoolwork can put too much stress on a child’s visual system, causing
problems even if none existed before. Whereas toddlers use their eyes mostly for
looking at distance, school requires children's eyes to focus on very close,
small work for hours every day. This can cause vision problems to arise. Children
don’t often realize that their eyes are under too much strain, and they rarely
report vision problems. Because their vision is "normal" to them, they
think everyone sees the way they do.
screenings provide a valuable service, but children can pass a school eye chart
test and still have undetected vision problems which are affecting their school
work. The eye chart just checks a child’s sharpness of vision, but reading
requires many other visual skills. The eye chart test can’t tell is a
child’s eyes are healthy, or if he can track a line of print without losing
his place, focus his eyes comfortably, or use his two eyes together for long
periods of time. School vision screenings are no substitute for a complete eye
examination by your family optometrist.
an Eye Doctor for Learning-Related Vision Problems
order to check if your child has developed adequate visual skills for success in school,
your choice of an eye doctor is very important. Routine
exams will check to see if your child's eyes are healthy and if he/she needs
glasses to see clearly, and all eye doctors can do this. However, children
who struggle in school need additional tests beyond a routine eye exam.
Here are some helps in choosing an eye doctor:
eye doctors who specialize in surgery and eye disease, and generally ophthalmologists
do not have training in this specialized area of care. You will need to
schedule an appointment with an optometrist, an eye doctor trained with an extensive
background in dealing with visual systems under stress, such as the demanding close
work and small print required for school performance. However,
many optometrists do not incorporate this specialized area of children's vision care within their
practice, so you're going to have to make additional inquiries. When
making the appointment, ask if the doctor can run eye teaming, focusing, and
tracking tests such as cover tests, vergence ranges, and the
Developmental Eye Movement test. If the doctor does not, then ask if he or
she can refer you to a colleague or specialist who does.
Ideally, you need a
pediatric optometrist who specializes in learning-related vision problems.
These optometrists are called
"developmental" optometrists, or sometimes "behavioral"
optometrists, who have received the professional credentialing of Fellow in the
College of Optometrists in Vision Development (FCOVD). Click here for more information about
developmental optometrists, or visit the website of the national certifying
board for pediatric optometrists at covd.org.
Vision Screenings for Infants and Three-Year-Olds
The early years of
life from birth until age five are crucial for a child’s visual development
and eye health. The American Optometric Association recognizes how
important it is to get your baby's vision off to a good start. InfantSEE™
is a free public health program for children during their first year of life;
participating AOA optometrists provide a comprehensive infant eye assessment at
no cost to the parents. Visit www.infantsee.org
for more information.
Kansas Optometric Association also sponsors the "See to Learn"
program. In order to identify vision problems in pre-school children, all
three-year-olds in Kansas are eligible for free vision screenings by
participating KOA optometrists. Contact your local Kansas optometrist for
more information, or visit the See-To-Learn web site at www.seetolearn.com.
you live in Wichita, Child and Family Optometry
participates in both the InfantSEE™ and See to Learn™ programs. We
invite you to call (316) 721-8877 to schedule an appointment.
Free Screenings for
School-Aged Children who Struggle
Wichita Vision Development Center invites parents of
school-aged children in
Wichita and south-central Kansas to schedule a free vision screening when they
suspect their child may be struggling with poor vision or inadequate visual
skills. The screenings are offered at
no cost or obligation as part of our community service commitment to help
identify at-risk children who are struggling needlessly because of poor vision. Click
here for more information or call (316) 722-3740 to schedule an