Parents have been asking me to focus on what to do if they are concerned about their infant’s or child’s vision. Well, let me see what I can see and say about this topic.

A newborn can see large shapes, faces and bright colors even at the time of birth. By 3 to 4 months of age, a baby can focus on smaller objects and tell the difference between colors such as red and green. By 4 months of age, a baby’s eyes should be working together to focus, and by 12 months, vision reaches normal adult levels.

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Baby’s first eye exam

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The American Academies of Pediatrics and of Ophthalmology recommend that children have their eyes examined at various ages and stages of their young lives. This should start when a baby is born. At that first examination of your newborn, your child’s health care professional can help check the eyes for visible defects. At 6 months of age, the alignment of the eyes should be checked. Beginning at 1 to 2 years of age, there are screening devices that can be used in most offices to detect potential problems with vision, and both the eyes and vision should be reexamined during preschool checkups to make sure a problem has not been missed. From 5 years and up, vision should be checked yearly, and if a problem occurs with the screening, then a visit to a pediatric eye specialist is recommended.

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Signs of vision problems

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If the pupil appears white or grayish at birth, that could be a sign of a cataract or rarely a tumor of the eye. In addition, a baby older than 3 months should be able to follow or track an object like a toy or ball as it moves across their field of vision. If not, referral to a pediatric eye specialist is also recommended. Another reason a pediatric eye specialist may be needed is if, after four months, the eyes inwardly cross or outwardly drift. This could weaken vision and require additional medical or surgical treatment.

Hopefully tips like these will eye-dentify what you need to know when you want to make sure your infant or young child’s eyes and their vision are doing well.

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Lewis First, MD, is chief of pediatrics at the University of Vermont Children’s Hospital of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.