All children should have an initial eye evaluation by a pediatrician within the first week of life. "A newborn's vision is 20/200 to 20/400," explains David B. Granet, MD, Director of the Division of Pediatric Ophthalmology & Ocular Motility, and Associate Professor at the Departments of Opthamology and Pediatrics at the University of California, San Diego. In layman, equivalent terms, "This is only the big E on the eye chart. Newborns also do not see color until they are a few months old."
At around three months of age, babies begin to smile. "This is the time when the visual system really starts to kick in and they interact more in the world. When a babies sees their parents smile, they begin to smile back."
By six months of age, a child's vision improves, and by age one, becomes comparable to that of an adult. "At this time they are focusing on things, right around the time they start walking," Granet says. During each well-baby examination, babies undergo a brief screening evaluation. Between ages one and three, the pediatrician will do a more extensive, age-appropriate screening.
"If a child has a serious issue such as cataracts or glaucoma, which should be detected by the pediatrician in the first couple of weeks of life, they need to be taken care of quickly," says Granet. "If not treated early, any blockage of vision early on in life can have permanent consequences on the developing brain, which may not allow the child to ever see."
Two other urgent concerns are corneal opacities, glaucoma and an eyelid that completely blocks the eye.