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What are the warning signs that a child might need glasses?

Immediately from birth doctors and health visitors are watching that babies develop normally and an important aspect of that is vision. There are recognised stages of visual development and your health visitor will be looking for these at various stages. If you have any doubts about your baby’s vision it is worthwhile discussing these at an early stage.

Soon after birth a doctor will examine baby’s eyes to check for congenital cataracts and retinal problems. A newborn baby cannot detect colour and cannot accommodate (focus on near objects) so eye movements appear to be random and vision is very blurred. After about a week a baby can detect red, green, yellow and orange but the blue receptor cells in the retina take longer to appear.

The two eyes may look in different directions in the first month but this becomes more coordinated.

During the second and third month the eyes work more as a pair and can follow a voice as it moves around a room and change focussing direction as a pair.

Six months is an important milestone. Vision is now about good enough to drive – about 20/25 or 6/9 – and colour vision is well developed. Hand-eye coordination is good – how often do they pick something up and try to eat it! – and the eyes work and move as a pair. A simple eye examination can be performed about 6 months of age although probably best to check that your optometrist or doctor is happy working with such young children.

As baby becomes more mobile and starts to crawl visual development continues but do provide a safe environment to minimise the chance of eye injuries.

Signs that something may be wrong or unusual in your baby’s visual development are always worthy of discussion so do not be afraid to ask. If you see misaligned eyes or an eye that is red, sore, weeping or sticky you should always ask your doctor or health visitor about it. In photographs the eyes should show two red reflections because they have huge pupils. If one or both pupils appear white it may indicate retinoblastoma and must be checked promptly. However, sometimes a white pupil in a photograph can be caused by the angle of the camera flash but do ask and do bring the photographs with you when you consult your doctor or optometrist.

If a baby seems to consistently cover or rub one eye or shield it there may be a problem and, again, it should be discussed. Furthermore if they become distressed on an eye being covered this may indicate a visual deficit.

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