How do I know if my baby has an eyesight problem? As a parent, it’s natural to be concerned about your baby’s health, especially when it comes to their vision. Babies cannot communicate like older children, so it can be difficult to know if they’re having trouble seeing. However, there are several signs and symptoms that could indicate a potential eyesight issue. From frequent eye rubbing to lack of eye contact, these clues can help you determine whether your baby may need an eye examination. Written by Inge Loubser, junior partner of the Mellins Full Service Optometry Group.
Research has shown that 20% of toddlers under the age of four do in fact suffer from vision problems. Much like children need to learn to walk and talk, they need to develop their visual acuity before they can make sense of their surroundings. But by the time a parent usually notices their child has a visual problem, the child’s visual acuity has reduced by more than 60%.
“Early detection of visual problems, eye conditions and early intervention is therefore critical in babies and young children”, says Inge Loubser, an optometrist of Mellins i-Style.
Although a newborn’s eyes are able to see as soon as it is born, vision is not nearly as advanced as that of an adult. At this stage your baby’s eyes are still evolving and cannot fully identify surroundings, they need to ‘learn’ how to see. Newborn babies first have to develop their own visual acuity, i.e. the skill that will allow their eyes to recognise certain details and to identify an object. Poor vision and impaired eye development, however, can severely delay your baby’s development and progress.
Early detection of any visual impairment is paramount in order to ensure that babies and toddlers are able to experience 20/20 vision as soon as possible. If you suspect any significant developmental delays, it is essential that you book a professional eye examination for your baby or toddler.
“If you suspect any significant developmental delays, it is essential that you book a professional eye examination for your baby or toddler.”
The importance of eye tests in babies
A newborn baby’s general eye health must be checked by a paediatrician or family doctor (general practitioner) at the hospital’s baby clinic. High-risk newborns (including premature babies) with a family history of eye problems or obvious eye abnormalities must be examined by an ophthalmologist.
“Today we are seeing many more infants with Retinopathy of Prematurity (ROP) than before and this is likely to continue as neonates of very low birth weight are routinely kept alive. Infants born to mothers that were substance abusers during their pregnancy, are also at an increased risk of prematurity and therefore also more likely to develop ROP,” says Inge.
ROP is a retinal vascular disease and is associated with supplemental oxygenation. It has subsequently led to a reduction in the frequency and degree of supplemental oxygenation given to premature newborns, which decreased the incidence of ROP, but led to increased morbidity and mortality.
The onset of ROP is likely to begin 32 to 42 weeks from the time of conception and the child should therefore be examined shortly after this time by a paediatric ophthalmologist. It is necessary to follow infants at risk of ROP for six months or longer after birth.
It is often difficult to perform an adequate examination on a tiny, crying infant. Eye drops are instilled to dilate the newborn’s pupil (the ‘window’ into the eye). An indirect ophthalmoscope is used, which has a special lens that sends a bright light into the eye, enabling the doctor to examine the fundus (the interior lining of the eyeball).
During the first year, all infants, as part of a routine examination, must undergo an eye health screening test by a paediatrician or family doctor.
Where can parents go for help?
Eye care and eye examinations should be part of your child’s routine medical care and there are different doctors offering eye care. See here for an explanation of the different titles:
For more eye care tips and advice visit www.mellins.co.za
BabyYumYum FAQs: How Do I Know If My Baby Has an Eyesight Problem?
Can babies have eyesight problems?
Yes. Although babies are born with limited vision, some may have underlying eye conditions that require early diagnosis and treatment to support proper visual development.
How can I tell if my baby can see properly?
From around 6 weeks, babies should start smiling in response to faces, making eye contact and following objects with their eyes. If these milestones are delayed, it’s worth checking with a healthcare provider.
Should I worry if one of my baby’s eyes turns in sometimes?
Occasional eye turning is common in newborns. However, if the eye turning persists beyond 3–4 months, it could be a sign of strabismus (squint), which needs professional assessment.
Can poor eyesight affect my baby’s development?
Yes. Clear vision is important for learning, movement, bonding, and speech development. Untreated visual issues can lead to conditions like lazy eye (amblyopia) or delays in other milestones.
When should I take my baby for an eye test?
If there are no concerns, a first eye check is often done by a paediatrician or clinic nurse. You can request a full eye exam by an optometrist or ophthalmologist if you notice any warning signs.
Is it true that eye problems can run in families?
Yes. If you or your partner has a history of vision issues, squints, or childhood glasses, it’s a good idea to get your baby’s eyes checked early even if no obvious symptoms are present.
Are eye tests safe for babies?
Yes. Eye tests for babies are gentle and non-invasive. Specialists use lights, shapes, and movements to assess vision, alignment and eye health even in children who can’t yet speak.
What if my baby needs glasses?
Although rare in infants, some babies do need corrective lenses for conditions like long-sightedness or astigmatism. Paediatric optometrists can prescribe soft, flexible frames suited to baby wear.
Can eye problems in babies be treated?
Yes. Many baby eye conditions, like blocked tear ducts, squints, or cataracts, are treatable if detected early. Early intervention often leads to the best outcomes for long-term vision.
What should I do if I’m concerned?
Speak to your clinic nurse, GP, or paediatrician. You can also contact a local optometrist or eye hospital for a referral to a paediatric ophthalmologist if needed.
Disclaimer: This information is for general guidance and does not replace professional medical advice. If you’re concerned about your baby’s eyes or visual development, please consult a GP, clinic nurse, or paediatric eye specialist as soon as possible.
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