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Early Signs of Vision Impairment in Infants and Toddlers

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Although it is normal for your baby’s eyes to look slightly, occasionally misaligned for the first three months, “after 4 months of age inward crossing or outward drifting that occurs regularly is usually abnormal” (4) and you need to call your doctor.

Your child should also be able to “fixate on an object, maintain fixation, and then follow the object into various gaze positions [track an object]. Failure to perform these maneuvers indicates significant visual impairment.” (5)

Observe how your baby’s eyes perform together (binocularly) and one at a time (monocularly). “If poor fix and following is noted binocularly after 3 months of age, a significant bilateral eye or brain abnormality is suspected, and referral for more formal vision assessment is advisable.” (5)


1) Optometric Clinical Practice Guideline: Pediatric Eye and Vision Examination. American Optometric Association. Web. Dec 9, 2012.

2) Your Infant’s Vision Development. Heiting, Gary OD. All About Vision. Web. Dec 9, 2012.

3) Developmental Signs of Eye Problems in Babies. Smith, Barbara M.S. OTR. Web. Dec 9, 2012.

4) Warning signs of Vision Problems in Children. American Academy of Pediatrics. Web. Dec 9, 2012.

5) Eye Examination in Infants, Children, and Young Adult by Pediatricians. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine and Section on Ophthamology et. al. Policy Statement. PEDIATRICS Vol. 111 No. 4 April 2003. Web. Dec 9, 2012.

Reviewed December 12, 2012
by MIchele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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