It is useful for parents to know the stages of development of a child’s vision, so that if they suspect that their child can’t see properly, or that there is a problem with his sight, they can get advice from a specialist promptly.
Problems with sight should be investigated if a child isn’t reacting appropriately to his environment. Most normal children’s vision matures in age-related stages. However, it is important to remember that children are different, there is a great variety in terms of maturity, and some children conquer steps in their development at different ages.
The newborn’s sight is fairly poor at birth. The human infant is born with an innate sense of smell and touch, so that it can orientate itself towards the familiar smell of its mother, and feel her touch. The newborn’s hearing is also good, so that he can respond to sudden, potentially dangerous sounds, by becoming restless, crying, and calling for help whenever needed.
Newborns can see at a distance of about 30 centimeters – the distance to mother’s face from the breast – , while closer and more distant objects become more blurred. He can focus on his mother’s face exactly at the distance between the breast and the eye of his mother, i.e. about 30 centimeters. Momentarily, he may be capable of following an object that is moving slowly within this space.
The blinking reflex functions from birth, i.e. the infant blinks every time he is exposed to strong light, or something touches his eye. The newborn’s eye-muscle co-ordination is not always good, and he may seem cross-eyed.
At one month
The infant’s vision continues to improve at 30 centimeters, focusing particularly on faces, pictures, and details with strong contrast between black and white. When he is alert, he may be able to follow an object with his eyes at 90 degrees. Tears begin to appear.
Up to three months
Up until now the infant has been able to focus on the details of a picture, and not on its entirety. Now he starts looking at, and can recognise the entirety of an object or a face. He can follow a light, a face, or an object from side to side (180 degrees). Accuracy of vision gradually improves, so he can also see further afield. He starts noticing and staring at his hands.
Up to five months
The infant looks at his hands. Visual accuracy has improved a lot, and he can focus at a longer distance (meters). He recognizes familiar faces, his mother’s breast, or the bottle. He looks at himself in the mirror. He starts reaching out to touch objects, and tries to put them in his mouth. Hand – eye coordination begins. He can grasp a toy that is hanging in front of him or over him.
Up to seven months
By now he has fuller development of visual accuracy. He can see colours clearly, and he looks further into the distance. He may develop preferences for specific colours, usually bright ones, such as red or orange. He turns his head to see an object. He touches his image in the mirror.
Up to 11 months
He can observe small objects with his eyes. He begins to get a sense of depth. He likes to play hide and seek. His capacity to follow fast-moving objects with his eyes increases.
Up to 14 months
He can place shapes in the appropriate holes of a box. He is interested in photographs and pictures in books. He recognizes familiar objects and pictures in books, and he can point to them with his finger. He recognizes his face in the mirror.
Up to 24 months
He can focus on objects, which are very close to him, as well as those further away. He makes lines with a pencil on paper, and he may copy a straight line or a circle when we show him how to do it. He can point to parts of the body when asked to.
Up to 3 years
The toddler can identify some basic colors. His vision is almost perfect, just like an adult’s, that is, 20/20. If we draw shapes, he can copy them, usually circles, or squares.
Up to 6 years
By the time the child is ready for primary school, his vision and hand-eye coordination have developed completely. He recognizes numbers and letters, and he is ready to learn to read. He has a complete sense of perspective and depth in pictures, and of objects near and far away. He can use scissors successfully and accurately.
Stelios Papaventsis MRCPCH DCH IBCLC 2011