Every August, pediatric clinics push through peak patient volumes of back-to-school well-checks and first-time vision screenings for young children. Pediatricians and other primary care providers (PCPs) evaluating developmental and behavioral milestones rank vision screenings among the most critical for identifying, addressing and preventing emerging conditions from worsening if caught and treated in the early years of life.
In a month of heightened emphasis on preventive pediatric eye care, the American Association of Ophthalmology (AAO) recognizes August as Children’s Eye Health and Safety Month. In this article, the AAO outlines markers of normal vision development from early-life foundational growth to arrival at adolescence. As PCPs and specialists guide parents through their growing child’s eye health, the AAO emphasizes the equal importance of teaching those approaching adulthood the importance of routine vision screenings and referrals for comprehensive eye exams over a lifetime in which all individuals age.
First Year (Birth – 12 Months):
Parents should watch for milestones that track normal development of vision in a baby’s first year. Pediatricians check for indicators that a baby’s vision is developing as it should and will name a few eye problems that parents should never ignore in observing their baby’s fast-developing eyesight.
1) Newborn – 2 Months: Adjusting to light and learning to focus. The retina develops in the first two months, and central, up-close vision is developing. Babies this age can see light and dark ranges and patterns. They primarily take interest in objects very close to them, large shapes and bright colors.
2) Two-Four Months: The eyes of a two- to four-month-old baby are learning to work together and track a moving object as their visual coordination improves. Watch for inward- or outward-turning eyes and delays in tracking moving objects. Bring these concerns to a pediatrician’s attention.
3) Five – Eight Months: By this point of infancy, babies have developed 3D and color vision. Parents should watch for reaching, recognizing, and recalling an individual or object from across the room as indicative of normal vision development of vision.
4) Nine – 12 Months: By one year, babies judge distance very well. Indicators of eyesight development at this age include learning to walk and crawl aided by clear vision that enables babies to grip, grasp, and move in a straight direction.
5) Two – Six Years – After the foundational first 12-18 months, children approaching age two have established visual “accommodation” (adjusting to shifting distances / strong depth perception, tracking and convergence). Normal vision milestones at this stage include enhanced hand-eye coordination, improved visual memory (recalling visual memories), ability to read an eye chart, letter and object recognition and advancing reading skills. An early-age child with fully developed depth perception moves within their environment confidently and easily takes on interactive activities such as sports.
6) (Early Childhood – Adolescence) – As children enter early grade school and grow toward adolescence, routine screenings like reading eye charts are the most efficient means of regularly checking a child’s eye health through easily accessible well-check settings. Pediatricians, family practitioners, nurses and other trained providers are all qualified to conduct vision screenings.
Screenings that detect signs of abnormal or delayed eye development secure referrals to an eye specialist who can conduct a comprehensive exam to detect and diagnose an emerging eye disease or condition. Children develop at different rates, yet they will increasingly display developmental delays in vision as individuals. The AAO lists signs of vision problems to look for as children grow toward adolescence, including head tilting, blinking or squinting a lot, or avoiding reading, any of which warrants scheduling a comprehensive eye exam with an individual.
From infancy through adolescence, the AAO and UNC Department of Ophthalmology emphasize to parents that delaying critical screening and diagnostic eye care can lead to lasting, irreversible effects if an emerging eye condition isn’t addressed early. On your checklist to prepare your child for the coming school year, schedule a vision screening with your child’s pediatrician or PCP. If a screening has already identified abnormalities that necessitate further diagnostic evaluation by an eye specialist, referrals for a comprehensive eye exam can be made by calling UNC Kittner Eye Center at 984-974-2020.
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