When to Get a Baby's Eyes Tested

Babies' eyes continually develop during the first two years.

Babies' eyes form early in the fetal stage. They can be damaged in utero if the mother experiences German measles or abuses illegal or prescription drugs. In rare cases, otherwise healthy babies are born with blindness or other eye problems.The eyes continue to form after birth, so it is important to have frequent eye exams to look for infection and other disorders.

Birth

A baby's eyes will first be examined soon after birth in the newborn nursery before the infant and mother are discharged. Here, a pediatrician screens for infections and disorders like cataracts, glaucoma, malformations and other abnormalities. If anything abnormal is detected, the pediatrician will recommend a course of treatment before the mother leaves the hospital and may refer the infant to an ophthalmologist. At this point, the eyes are still developing, so disorders may not be detected at the first exam.

One to Two Months

The next eye exam will take place at the first well-baby check-up and every check-up after that. The American Academy of Pediatrics recommends check-ups for infants at 1 month, 2 months, 4 months, 6 months, 9 months and 1 year. 

A thorough infant eye exam should include questions about family vision history. The pediatrician will examine the eyelids and eyeball with a penlight for signs of tear duct blockage, infection, allergy and disease. The doctor checks pupil size and that eyelids do not droop, and the position of the eyes, lids and lashes for malformations. The doctor checks eye movement, reflection of light from the back of the eyes and dilation, which can indicate the presence of cataracts, tumors and other disorders. 

Babies are usually born with healthy eyes, but there are several disorders the pediatrician, optometrist or ophthalmologist will screen for at the early visits. Some babies are born with blocked tear ducts, which can lead to infection. Babies will not cry tears until 6 to 10 weeks or later, but problems of the ducts can be resolved earlier than this.

Four to Six Months

A baby's first eye exam with a specialist --- an optometrist or ophthalmologist --- is recommended at 6 months. Even if significant eye problems have not been detected by the pediatrician, the specialist will screen for several potential disorders. Cataracts do not only ail the elderly; babies are sometimes born with a cloudiness of lens, and surgery may be required to correct it.

Strabismus is a misalignment of the eye. Eyes turned in (esotropia) or out (exotropia) can lead to vision problems, and these are diagnosed after 4 months when the eyes should be steadily aligned. Before 4 months, the eyes continue to move, so your doctor may choose not to treat strabismus immediately. Amblyopia, or "lazy eye," can be treated non-invasively with glasses. Ptosis, or a droopy eye lid, may require surgery to correct.

Nine to Twelve Months and Beyond

After the 6 month exam with a specialist, most physicians agree that the well-baby check-ups are sufficient to monitor development of the eyes. Toddlers continue to have regular check-ups every six months until they turn 2. Children should see a pediatrician for regular annual exams, and he can detect potential problems with the eyes.Beginning at 3, the child should start seeing a specialist for regular eye exams. The American Academy of Pediatrics and American Academy of Ophthalmology recommend screenings at birth, 6 months, 3 to 4 years of age, 5 years old before kindergarten and every year after that. The American Optometric Association recommends screenings at 6 months, 3 years, 5 years and every two years after that.

If a baby is at risk for vision problems that run in the family, it is wise to schedule annual visits to correct problems before the child enters school.