Very young infants see quite poorly - they cannot differentiate between two targets or focus on objects more than 8-10 inches away. In fact, the reason most toys for infants are black and white is because for their first few months of life, babies can’t see color the way adults do. By around two months of age, they begin to focus on the faces of their parents more easily. Babies should begin to track moving objects and reach for things around three months. It is also not unusual to see them cross their eyes prior to 3-4 months as they begin to develop control of eye movements and coordination. By 6 - 9 months of age, most infants will have developed basic visual skills and begin to really challenge and train their vision systems.
As this fairly rapid visual improvement occurs within the first year, two significant medical eye conditions may be detected prior to age 1 - Amblyopia (Lazy Eye) and Strabismus (Crossed-Eye, Wall Eye). The earlier these conditions are detected, the more effectively and quickly they can be treated. Baby’s first eye exam should be at age 6 months to 18 months. InfantSee exams are comprehensive assessments offered free of charge for babies up to 12 months of age.
The preschool years are an extremely important time of vision development. By age 2, the eyes will have physically developed to the size they will remain for the rest of their lives! But simply reaching optimal size does not immediately bestow optimal sight on a child.
Critical basic vision skills, including fixation, eye movement control, focusing, and eye teaming, are all being developed at this time and are important building blocks for the more challenging visual tasks such as reading and writing, which lie just ahead. Eye-body coordination, especially eye-hand coordination, is closely related to vision development (VIGS, VIPS, VMPS). Activities such as stacking building blocks, rolling a ball back and forth, puzzles and arts and crafts all help improve these important visual skills. Reading to your child helps them develop strong visualization skills as they imagine the story in their mind. Comprehensive eye exams during this period will detect the early onset of vision problems not caught during vision screenings.
For a child's visual system, these are the most challenging of the formative years. Reading, writing, and copying are taught in progressively challenging steps, from learning ABCs and sight words in preschool and kindergarten, to more challenging reading and writing assignments in grades 1-5 and beyond. Print gets smaller, chapters get longer, and the smartboard becomes an increasingly important tool for conveying information.
While most will make a smooth adjustment, as many as 1 in 4 school aged children have some type of undiagnosed vision disorder. Up to 75% of vision screenings at school or annual physicals miss vision problems as they only measure acuity at 20 feet. The 20/20 Eye Test is not a good predictor of a child's ability to read easily or to process what they’ve just read. Annual eye exams test visual acuity at all distances, as well as the health of the eyes. An evaluation with a behavioral optometrist will further test the visual skills (eye teaming, eye movements, focusing ability, and processing) necessary for a student to reach his or her potential.
A child may have learned to read by first or second grade with little or no difficulty. As demands increase in third and fourth grades, and the child is required to read longer books in smaller print, reading problems can start to appear. Words may be misread or missed, frequent loss of place may occur, complaints of fatigue or headaches may arise; all of which can lead to a decreased desire to read and even total avoidance of reading or schoolwork. When this happens, children are often labeled as lazy or defiant. This is, of course, often not the case as most young children try very hard to please their parents and teachers.
Students with these types of correctable visual skills deficits tend to compensate using rote memorization and other methods. However, as schoolwork becomes more demanding, keeping up becomes such a struggle that frustration, anxiety and avoidant behaviors come into play.
The critical take-away here is that if a child has learned (and even loved) to read in grades K-2, and then reading problems subsequently occur, the child should be seen for comprehensive visual evaluation performed by a developmental optometrist.