Learning To See

Did you know that Newborns have all the eye structures necessary to see, but they haven’t learned to use them yet? Your baby holds the eyes roughly straight at birth from the BALANCE centers in the brain, NOT the vision centers.  This tells you how much work has to be done to see normally.  Thus, VISION IS A LEARNED SKILL, NOT an automatic one. 

Birth to Four Months  

When they’re born, they don't have full color vision. Babies are perfectly set up to focus on MOM, especially while feeding at breast or bottle.  They first 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 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!  

Four to Six Months

As 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. 

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 put together the pictures coming in from both eyes into a single image for "two-eyed" vision with strong depth perception.

They refine their eye teaming and focusing skills as they learn to look quickly and accurately between near and far distances. Normal sharpness of vision has usually developed to 20/20 by the time the child reaches six months. 

Six to Eight Months  

Most 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.  

By the sixth month, babies acquire fairly accurate eye movement control. 

Eight to Twelve Months  

Babies can now judge distances well. Eye/hand/body coordination allows them to grasp and throw objects fairly accurately. 

The integration of their vision and eye hand 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 movements.  

Toddlers and Preschoolers  

Children’s 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. 

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.  Call us today to set this up!!

School-Aged Children  

IT'S CRITICAL to have a complete eye examination before starting school.  Only one child in 7 does this.  Your pediatrician can NOT do this. 

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.  

School vision 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 (20/20), 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.  

Choosing an Eye Doctor for Learning-Related Vision Problems

In 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 help in choosing an eye doctor:

Ophthalmologists are surgeons, optometrists are not.  There is a large overlap between the two professions for non surgical needs.  But if you don't need surgery, you don't need a surgeon.

However, MOST optometrists aren't specially trained in children's vision care. WE ARE. We have the largest, busiest kid's vision practice in Kansas.   When you call, you must have the 3 PILLARS of VISION checked.  Ideally, you need a pediatric optometrist who specializes in learning-related vision problems.  These optometrists are called "developmental" optometrists, and they are credentialed and board certified.  See COVD.ORG for more information.


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