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Published in Calgary Child’s Magazine: infant vision

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As a new mother and optometrist, I understand the important role parents play in the eye and vision development of their infant. Healthy eyes and good vision contribute to helping infants see well and prevent developmental delays. There are three steps I encourage parents to take when it comes to vision. Firstly, parents should watch for signs of eye and vision problems early on. Secondly, they should have their child’s eyes examined by an optometrist at six months of age. Early detection leads to better treatment outcomes. Thirdly, engaging in age-appropriate activities helps to stimulate the eyes and vision. Similar to walking and talking, a baby learns to see over time. Visual abilities such as focusing (accommodation); moving the eyes accurately (eye tracking); using the eyes together (eye teaming); and the brain processing what it sees (visual processing) are learned skills. In fact, 80 per cent of learning occurs through vision, so why not give your infant the best chance at life?

INFANT VISION DEVELOPMENT

The following are eye and vision milestones to watch for from birth to 12 months. Note: Every child is not the same, and some may reach certain milestones at different ages.

Birth to six months

  • Studies indicate the sharpness of vision or visual acuity begins around 20/400 at birth to approximately 20/25 (adult-like) at six months of age.
  • At birth, an infant sees in black and white and shades of grey as nerve cells in their retina are not fully developed. By six months of age, color vision should be similar to that of an adult in that all colors are seen.
  • The eyes are able to focus on objects placed within 20 to 30 centimetres of an infant’s face. Babies are drawn to highly contrasted targets, such as the face of their mother. By eight weeks, babies begin to focus with more ease.
  • The eyes are not well-coordinated at birth and one eye may appear to wander upward, downward, inward (crossed) or outward. If the eyes have a large or constant misalignment, notify your optometrist right away. By six months of age, the eyes work together and depth perception is established.
  • The eyes begin to follow moving objects at three months of age.
  • At three months of age, an infant’s ability to detect light is 10 times that of an adult. Diming the light for naps and bedtime is recommended.
  • Babies have better hand-eye coordination by four to six months allowing them to accurately locate and pick up objects, such as their feeding bottle.
  • Mark it on your calendar! At six months of age, book your child’s first eye exam with an optometrist.

Seven to 12 months

  • Control of eye movements continues to improve.
  • Between nine and 12 months, infants develop better awareness of their body and learn to coordinate vision with body movements. Parents should encourage crawling rather than early walking to help the child develop better eye-hand-foot-body coordination.
  • Infants are better at judging distances and more accurate at grasping and throwing objects.
  • Eyes can change color as more dark pigment is produced in the iris changing the eye color from blue to brown, green, grey or a mixture of colors.

ACTIVITIES FOR VISUAL DEVELOPMENT

The following are suggested activities for visual development by the American Optometric Association and my own personal experience:

Birth to six months

  • Use a night light to provide visual stimulation when the infant is awake in their crib at night.
  • Add new items to their room, change the location of their crib and your infant’s position in it, and change the location of existing items in the room.
  • Keep reachable toys within your infant’s focus (20 to 30 centimetres). Have your infant watch a brightly colored object (balloon, ribbons, and pinwheel) and move the object from side to side and up and down to help strengthen the eye muscles, track objects and focus at different distances.
  • Your voices and various noise makers (squeaky toys) help your infant develop visual tracking and auditory location skills. Dangling objects will sharpen your infant’s auditory and visual discrimination skills.
  • Talk to your infant as you walk around the room.
  • Faces are very important to infants. Use facial expressions such as a smile, an opened mouth, raised eyebrows, a stuck-out tongue or simply saying their name while maintaining eye contact helps stimulate vision and bonding. Having the infant gaze into a mirror or showing them a book with various facial expressions helps the infant’s eyes to focus and track and explore the social nature of faces.
  • Alternate right and left sides with each feeding.
  • Building blocks, a small plush toy or a teething ring attached to a brightly colored ribbon dangled in front of an infant can help boost fine motor skills and small muscle development as they try to reach for the toy.

Seven to 12 months

  • Hang a mobile or line art with various objects across the crib for the infant to grab, pull and kick. Having you standing close by and talking about the objects captures the infant’s attention and provides a chance for both of you to interact.
  • Becoming dexterous requires fine control of the wrist, palm and fingers, as well as the ability to judge distances and shapes. Plastic measuring cups and spoons are great toys as they are easy to grasp and have different surfaces.
  • Play patty cake and other games, moving the infant’s hands through the motions while saying the words aloud.
  • Play hide-and-seek games with toys or your face to help the infant develop visual memory.
  • Name objects to encourage the infant’s word association and vocabulary development skills.
  • Give the infant plenty of time to play and explore on the floor. Encourage crawling.
  • To stimulate eye-hand-body-coordination, place a toy on the floor and encourage them to get it. Provide plenty of objects and toys that they can take apart and put together helping with hand-eye coordination and visual discrimination.
  • Emptying and filling containers helps develop spatial awareness such as big, small, empty or full. It also exercises fine and gross motor skills.

INFANT’S FIRST EYE EXAM

Although your infant cannot read the wall chart in an optometrist’s office nor can they tell you if they are seeing well, your optometrist is able to provide an accurate and complete eye examination using non-verbal testing to check the level of vision (visual acuity); excessive or unequal amounts of nearsightedness, farsightedness or astigmatism; eye focusing, tracking and eye teaming; and eye health problems.

Schedule the eye exam at a time when baby is relaxed and happy. Fill out any required paperwork at home and bring in on the day of the exam. Bring along a familiar toy to calm your baby if they start getting fussy as the initial eye exam can take up to 30 minutes. Further examination such as a dilated fundus examination may be required to check the posterior structures of the eye (the retina) and/or verify if a prescription for glasses is needed. Be proactive about your infant’s eye and vision development, it will pay off for their lifetime.

Dr. Farrah Sunderji, OD, completed her Optometry degree from the New England College of Optometry followed by a residency in Pediatrics and Vision Therapy. Her practice EyedeologyTM is located at #245, 520 – 3 Avenue SW. For more information on children’s vision, check out her website at eyedeology.ca.

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Supporting Ocular Surface Healing and Comfort

The membrane contains natural growth factors and anti-inflammatory properties. When placed over the cornea, it acts as a protective layer that supports healing and may help reduce inflammation.

Potential Benefits

  • Supports Healing: Helps promote natural healing of the eye’s surface.
  • Reduces Inflammation: Its natural properties may help calm inflammation.
  • Improves Comfort: May help relieve discomfort related to dry eye.
  • Supports Recovery: Helps support the healing of the ocular surface.

Who May Benefit?

Amniotic Membrane Therapy may be suitable for people with moderate to severe dry eye, particularly when conventional treatments have not provided enough relief. An eye care professional can assess your eyes and determine if this treatment is appropriate.

How Does It Work?

The amniotic membrane is the innermost layer of the placenta and contains growth factors and anti-inflammatory properties. During treatment, a specially prepared membrane is placed over the eye’s surface to act as a biological covering and support healing.

What to Expect

Before treatment, your optometrist will examine your eyes and determine whether Amniotic Membrane Therapy is suitable for you.

  • Before Treatment: The eye is numbed with topical anesthetic drops, and the area is prepared.
  • Membrane Placement: The preserved and sterilized membrane is placed over the cornea.
  • After Placement: A special contact lens may be used to hold the membrane in place.
  • Post-Treatment Care: Antibiotic or anti-inflammatory eye drops may be prescribed when needed.
  • Follow-Up: Regular visits help monitor healing and the membrane’s absorption or integration.
Some patients may experience mild discomfort, a foreign body sensation, or temporary blurred vision after treatment. Improvement in symptoms may take anywhere from a few days to several weeks, depending on the individual.

Understanding Dry Eye and Your Treatment Options

Dry eye can develop for several reasons, and understanding the underlying cause is an important part of managing symptoms. Our team can assess your eyes and help develop a management plan based on your individual needs.

Common Symptoms of Dry Eye

Dry eye can affect both eyes and may cause different symptoms, including:

  • Stinging or Burning – A burning, stinging, or gritty feeling in the eyes.
  • Eye Redness – Red or irritated eyes.
  • Light Sensitivity – Increased sensitivity to light.
  • Excessive Watering – Eyes that water more than usual.
  • Blurred Vision or Eye Fatigue – Blurry vision or tired, strained eyes.
  • Foreign Body Sensation – A feeling that something is in your eye.

What Causes Dry Eye?

A healthy tear film has several components that work together to keep the surface of the eye comfortable and protected. Dry eye can occur when tear production decreases or when tears evaporate too quickly.

Several factors may contribute to dry eye, including:

  • Aging
  • Allergies
  • Hormonal changes
  • Eyelid problems
  • Gland dysfunction
  • Certain health conditions
  • Living in a dry climate
  • Extended screen time

One common factor is blockage of the Meibomian glands, which produce the lipid layer of the tear film. When these glands are not functioning properly, tear evaporation can increase and contribute to dry eye symptoms.

A Personalized Approach to Dry Eye Management

Managing dry eye involves more than simply using eye drops. Our team can help develop a personalized plan that may include targeted in-office treatments, nutritional guidance, and home care based on your needs. 

Home care may include:

  • Warm Compresses: Used as part of a regular eye-care routine.
  • Lid Hygiene: Keeping the eyelids and surrounding area clean.
  • Artificial Tears: May be recommended to help manage dryness and discomfort.

In-Office Treatment Options

For patients with more severe dry eye symptoms, targeted in-office treatments may be considered. Available options include:

  • Radiofrequency
  • Intense Pulsed Light Therapy (IPL)
  • LipiFlow Therapy

These treatments may be used as part of dry eye management for symptoms such as burning, itching, redness, and irritation. The appropriate approach depends on the underlying factors contributing to your symptoms.

Managing Your Dry Eye Symptoms

Dry eye can have several contributing factors, so treatment is not the same for everyone. A thorough assessment can help identify factors affecting your tear film and determine which management options may be appropriate.

If you are experiencing persistent dryness, irritation, redness, light sensitivity, or other symptoms, speak with our eye care team about your dry eye management options.

Deep Cleansing for Healthier Eyelids and Lashes

ZEST (Zocular Eyelid System Treatment) is an in-office eyelid cleaning and debridement treatment developed by Zocular®. It is designed to clean the eyelids and lashes while helping address concerns associated with dry eye, blepharitis, and demodex.

The treatment uses a natural, okra-based gel to remove oil, debris, and residue from the eyelid margins and lashes. By improving eyelid hygiene, ZEST can help reduce the buildup that may contribute to irritation and inflammation around the eyes.

What Is ZEST?

ZEST works like a deep cleansing treatment for the eyelids and lashes. During the procedure, the okra-based gel is applied along the eyelid margins and lashes using a cotton swab. The gel is gently worked into a lather using circular motions before being rinsed away with saline solution.
The gel contains a refined extract of okra, an edible green seed pod. According to the provided product information, okra helps lift and clear oil, debris, and residue while being gentle around the eye area.

How Can ZEST Help?

Keeping the eyelids, eyelid margins, and lashes clean is an important part of eye hygiene. Buildup along the eyelid edges can contribute to symptoms such as itching, burning, gritty sensations, redness, and irritation.

ZEST is designed to address this buildup through thorough cleansing and debridement.

  • Removes Debris: Helps clear dirt, oil, and residue from the eyelid margins and lashes.
  • Supports Eyelid Hygiene: Provides a deeper cleansing treatment than routine eyelid cleaning.
    Addresses Demodex: The treatment is designed to help remove demodex mites and associated debris.
  • Helps Reduce Inflammation: Cleansing the eyelid area may help address buildup associated with irritation and inflammation.
  • Supports Dry Eye Care: ZEST may help relieve symptoms associated with dry eye and poor eyelid hygiene.

ZEST for Dry Eye, Blepharitis, and Demodex

Dry eye and blepharitis can be associated with inadequate eyelid hygiene. Debris along the eyelid margins can enter the tear film with blinking, potentially contributing to redness and irritation.

Demodex mites can also be present in the hair follicles around the eyelashes. According to the provided information, they may contribute to inflammation and dry eye symptoms by blocking the oil glands at the base of the eyelashes.

ZEST provides targeted cleansing of the eyelid margins and lashes to help remove this buildup and address demodex-related concerns.

A Simple In-Office Treatment

The ZEST procedure is performed in the office and involves applying the cleansing gel to the eyelid margins and lashes, working it into a lather, and then rinsing the area with saline solution. The treatment is designed to provide thorough eyelid and lash cleansing without requiring a lengthy procedure.

Is ZEST Right for You?

ZEST may be considered for patients experiencing symptoms associated with dry eye, blepharitis, demodex, or eyelid debris. An eye care professional can assess your symptoms and determine whether ZEST is appropriate for your eye care needs.
587-317-2134