Eye Exams in Your Baby's First Year

Medically Reviewed by Whitney Seltman, OD on November 07, 2022
3 min read

Does your baby really need an eye exam in their first year? Absolutely.

The doctor should check their eyes at each visit that first year. If your baby is premature and born in less that 34 weeks, has a family history of cataracts, eye tumors, and other inherited diseases, a specialist should check them while they’re still in the hospital nursery.

At every routine doctor visit during the first year, your baby should be checked by their regular pediatrician to make sure:

  • Each eye focuses
  • Their eyes are straight
  • They don’t have an internal eye disease

If you catch and treat eye conditions early, you’ll spare your child lifelong vision issues and boost their overall health.

The eye exam your baby had at birth is a great start -- but it’s only a start. If they have problems, you'll want to find them during the first year so treatment can start while their eyes are still developing.

Their vision will change as they grow. First, they’ll notice things that move. In their first full week of life, if they’re a full-term baby, they’ll be able to see facial expressions (like their parents' happy smiles). It takes a little longer, but soon they’ll be able to spot colors and gain some depth perception. Their eye muscles will begin to work together.

As a parent, you know your child best. If you notice or suspect that their eyes turn in or out, or if the pupils appear white in photographs, call your doctor right away.

If they were premature, make sure your baby gets an eye exam before they come home. If you're home now and not sure they had one, ask. If no exam took place, make an appointment with an eye doctor as soon as possible.

During this first year, be on the lookout for signs of eye or vision problems:

  • Strabismus: Their eyes aren’t aligned and don't move together.
  • Nystagmus: Their eyes seem to jump or wiggle around longer than after the first 3 months
  • Any eye injury or physical change that concerns you.
  • Any sign that their sight isn’t developing properly.

Your baby's doctor (a pediatrician or family doctor) should include a basic eye exam and look for vision problems during each checkup in the first year. They can treat minor eye health problems like infections.

If there’s a problem, your baby should see an eye specialist. To find one:

  • Get a referral from their doctor.
  • Ask family members or friends to suggest one.
  • Check your health plan for a list of eye doctors in your area.

Before you go, make a list of any questions you have. In case you'll need to wait, bring a favorite toy or something else your baby can play with quietly. Bring a snack, too.

Every well-baby visit should include:

  • A family history of eye health or vision problems.
  • A penlight exam of eyelids and eyeballs: Are their pupils the same size? Are their eyelids firm, not droopy? Is there any sign of infection, disease, tearing problems, or allergy? Do their eyes, lids, and lashes appear normal?
  • Eye movement check (each eye and both together): How well does your baby follow an object (often a toy) as the doctor moves it about? Both eyes should respond the same. If not, there could be a problem.
  • Light reaction test: You’ll take your baby into a darkened room so their pupils can open up. That gives the doctor a better view inside their eyes. The doctor will use a tool to look for a red reflex in your baby’s eyes. They’ll check them one at a time and then together. An abnormal response could signal problems like cataracts or tumors.

Although most doctors know how to check babies’ and children’s eyes, yours may suggest your child get another exam, even if they don’t find vision problems. Experts have different opinions on vision screening for children. Ask your doctor what’s right for you.