Vision

DRAFT:  This information in the Vision section is currently out for review by Pediatric Ophthalmology consultants.

Early Visual Development

Birth

• Basal tear production (the continuous tearing to keep the eye surface moist) in the full-term infant is similar to that of an adult
• Visual acuity equivalent to Snellen 20/400
• Infant can’t focus farther than 8-15 inches away, so prefers looking at close objects, especially objects with sharp contrast or bright colors

1-2 months old

• Able to fix eyes on an object, light or face.  Focus is brief with a gaze shift after a few seconds
• Pupillary light reaction is well developed

2-3 months old

• Color vision is present
• Visual fixation is well developed by about 2 months
• Infant moves eyes and head together
• Eyes track (smooth visual pursuit) targets vertically and horizontally, visual following is well developed by about 3 months
• May have blink reflex to visual threat

4 - 6 months

• Regards face or interesting object with steady conjugate gaze in all fields of vision
• Visual acuity reaches equivalent of Snellen 20/30; vision is good enough to notice small details
• Eyes should be well aligned
• Reaches for and grasps objects; depth perception is maturing
• Eyes track without moving head
• Eyes track past midline
• Blink reflex to visual threat is present

7-12 months

• Color vision at adult levels
• Depth perception is developed
• Notices small objects
• Coordination between vision and gross and fine motor movement/hand coordination is increasing

1 year old

• Focus on an object is consistent. Child will visually follow an interesting object as it is moved peripherally

2-3 years old

• At about 2 ½ to 3 years of age many normally developing children can complete visual acuity testing with picture cards, matching activities, or similar tests. (See age appropriate visual acuity testing)

7 years old

• Stereoacuity (depth perception or binocular vision) at adult level