Eye Exams in Your Baby's First Year

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

The doctor should check his 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 him while he’s still in the hospital nursery.

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

  • Each eye focuses
  • His eyes are straight
  • He doesn’t have an internal eye disease

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

Why All the Follow-Ups?

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

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

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

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

When Does Your Baby Need an Eye Exam ASAP?

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

  • Strabismus: His eyes aren’t aligned and don't move together.
  • Nystagmus: His 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 his sight isn’t developing properly.


Who Does the Exams?

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. He 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 his doctor.
  • Ask family members or friends to suggest one.
  • Check your health plan for a list of eye doctors in your area.

First-Year Eye Exams: What to Expect

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 his pupils the same size? Are his eyelids firm, not droopy? Is there any sign of infection, disease, tearing problems, or allergy? Do his 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 his pupils can open up. That gives the doctor a better view inside his eyes. The doctor will use a tool to look for a red reflex in your baby’s eyes. He’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 he doesn’t find vision problems. Experts have different opinions on vision screening for children. Ask your doctor what’s right for you.

WebMD Medical Reference Reviewed by Dan Brennan, MD on June 02, 2020


Vision Council of America web site: "Infants, Preschool, School Age."
All About Vision web site: "Your Infant's Visual Development."
Baby Center.Com web site" "Eye examinations for Babies."
National Eye Institute web site: "Finding an Eye Care Professional."
Prevent Blindness America web site: "Taking Your Child to the Eye Doctor."
American Academy of Pediatrics: "Eye Examination and Vision Screening in Infants, Children, and Young Adults."

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