With so many babies being born in Suffolk County we often see parents who are not only concerned that their baby’s eyes are normal, but they are also curious about just what they can see.
While their distant vision is poor they have reasonably good vision up close. This is important since they are able to focus and recognize their parents faces when being fed. Parents are often gratified to see their baby fixating on their face at these times. They also seem to have an instinctual knowledge for being able to differentiate between a happy, smiley face and frowning and unhappy face. Failure to fixate on your face in the first few weeks or months could be a cause for concern that should be brought to the attention of your pediatrician.
Muscle coordination is poor initially and your baby may appear “cross eyed.” While this is not a great concern initially they should straighten out by the third to fourth month. but a large, constant misalignment, even if it is early on should be a cause for concern. In the first two to three months vision rapidly improves. At this time an infant can follow objects and even start to reach for them.
Color vision is thought to be poor at birth as babies initially see mainly black and white since their cones are not fully functional, but at a week they are already able to see red, orange, yellow and green. The ability to recognize blue and violet develops somewhat later.
By six months of age an infant’s vision is virtually as good as an adult’s. While it may only be approximately 20/400 at birth by six months it may be as good as 20/25.
Changes in eye color can occur anytime in the first year. This is because the stromal tissue overlying the colored iris surrounding the pupil of your eye is undeveloped in the first year of life. As your infant grows in the first year the iris stoma often changes in color.
One big concern that parents may encounter is if their infant was born prematurely. While this is often not a problem it can be if the infant was born before 30 weeks of gestation or was less than 3.3 pounds (1500 grams) at birth. This is because the vessels in the retinal periphery are not fully developed. When these premature infants are given supplemental oxygen which they require for survival, abnormal vessel formation can occur. This entity called ROP for retinopathy of prematurity must be diagnosed and treated immediately as it can lead to retinal damage with partial or total retinal detachments that can in turn lead to blindness. While this condition cannot always be perfectly treated, excellent sight saving treatments are often available. These consist of cryoablation, photocoagulation, and more recently the use of vasular endothelial growth factor inhibitors which are also used to treat macula degeneration.