Vision problems first appear during infancy and early childhood. “Parents are important observers because they notice 99 percent of their children’s eye problems,” says Leslie Green, MD, an ophthalmologist who works with Eye Physicians of Orange County. “Babies should be observed for eyes that wander inward, eye lids that look droopy, or eyes that tear excessively. They should be able to fixate on and follow crib mobiles by three months.”
If you notice your baby shows signs that eye problems may be present you should contact your pediatrician who will refer you to a pediatric ophthalmologist, who has special training and expertise in working with children, if necessary. Although it is rare, cataracts can occur during infancy. A cataract clouds the lens of the eye and interferes with normal vision.
“If you are concerned about cataracts you can check your baby’s vision by shining a small flashlight into the pupil of each eye,” Green says. “The normal pupil’s response when light hits it is a red, reflex reaction. Should you see a white reflex reaction, your baby may have a cataract and should be seen by an ophthalmologist. Ophthalmologists can diagnose and treat cataracts but usually refer babies and small children to a pediatric ophthalmologist for care.”
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Premature babies are at particular risk for vision problems because their eyes need more time to develop than those of full-term babies, Green explains. Pediatric ophthalmologists first examine these babies while they are in hospital neonatal intensive care units and continue to monitor them when they go home. The medical goal is to rule retinopathy, an eye condition that can occur in premature babies. Retinopathy can damage delicate blood vessels that form in the retina, an eye structure located at the back of the eye that allows light to enter it.
Babies continue to be monitored to assure they are not nearsighted or have lazy eye. As they become toddlers they are at higher risk to develop strabismus (an eye condition that causes “cross eyes”) because a child is unable to align both eyes at the same time.
“Children with strabismus do not outgrow this eye condition and need to wear glasses,” Green says. Although not all premature babies have eye problems, those who do are referred by pediatricians to pediatric ophthalmologists for further evaluation and treatment.
Joan Fox Rose is a freelance writer living in Saratoga Springs.