Thursday, September 25, 2014


Inspired by the book Hello, Cupcake!
InfantSEE® is a public health program that is designed to ensure that eye care becomes an integral part of infant wellness care.  If your child is between 6 months and 12 months old, an InfantSEE® provider will perform a one-time comprehensive infant eye assessment at no cost to you.  This allows the opportunity for early detection of risk factors that might lead to potential eye and vision problems.  Many eye conditions do not have signs/symptoms that can be easily identified by a parent or pediatrician.  

The American Optometric Association (AOA) recommends an eye exam at 6 months of age, yet only 18% of parents reported that their infant had received a comprehensive eye exam before age 1, according to the Eye-Q survey conducted by the AOA in 2011.  Vision development has stages, and many development milestones relating to the eye and vision have been reached at 6 months.  Even though some skills reach near-adult levels in infancy, the visual system continues to develop through childhood.

Optometrist rely on patient and family history along with objective testing to determine if a baby has or is at risk for having a vision or eye problem.  Although problems are not common, it is important to identify children who have specific risk factors at this stage.  Vision development and eye health problems can be more easily corrected if treatment is begun early.  There are four main areas that are evaluated during an infant vision and eye assessment:

1.  History:  The optometrist will ask questions relating to the pregnancy, delivery, and development of the child.  Some risk factors for potential eye problems include premature birth, low birth weight, high levels of oxygen therapy, low APGAR scores, and a strong family history of eye problems.

2.  Vision:  Obviously, a baby will not be able to read the letters on the eye chart or tell the optometrist that choice 2 is better than choice 1.  Instead, the optometrist will use objective, non-verbal techniques to estimate the child's visual acuity and refractive error (nearsightedness, farsightedness, astigmatism).  High amounts of refractive error in one or both eyes is a risk factor and will need to be monitored more closely and/or treated to ensure proper visual development.  When these issues are caught and treated early, vision loss in the form of amblyopia can be avoided.  A more detailed description of amblyopia and refractive errors can be found in the back-to-school post.

3.  Eye alignment:  Besides assessing vision, the optometrist will also be checking to see if the infant's eyes are aligned and working together. These skills are not fully developed in the first few weeks of life.  Constant and/or significant eye deviations noted at the InfantSEE® exam may require treatment with glasses/contact lenses or surgery, depending on the type of eye turn.  As mentioned above, these issues need to be addressed early on to ensure proper visual development.   

4.  Ocular health:  The optometrist will use handheld instruments to assess the health and function of the structures of the outer eye.  He/she will also use an eye drop or spray that dilates the baby's pupils to check the health of the inner eye.  

If all is well at the InfantSEE® exam, the next time a child should be seen by their optometrist is at 3 years of age, or sooner if a problem/concern arises.

For more information, and to find an InfantSEE® provider near you, please visit

CliffsNotes: Babies need eye exams too!  

Additional recommended resources: