Harmony Vision Behavioural Optometrists

Category Archives for Baby & Infant Vision

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Glasses for Infants and Toddlers on the Gold Coast

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Is It Really An Eye Turn? So What is Pseudostrabismus?

Key Takeaways

• Pseudostrabismus looks like an eye turn but is caused by facial features, not actual eye misalignment.

• Pseudostrabismus is common in infants and young children due to wide nasal bridges or prominent epicanthal folds.

• True strabismus must be ruled out because it can affect depth perception and lead to amblyopia if untreated.

• A paediatric optometry exam differentiates pseudostrabismus from true eye-turn using alignment and binocular vision tests.

• Early identification ensures appropriate monitoring and timely treatment if actual eye misalignment develops.

Pseudostrabismus refers to eyes that appear to be turned, but are actually straight. This is quite a common condition in babies and young children due to facial structures. Known as “prominent epicanthal folds”, the wide bridge of the nose and the inner folds of the eyelid skin on the nose-side of the eye contribute to the appearance by covering the “whites” of the eye. This is often more noticeable in of East Asian ethnicities, where the lower fold of the upper eyelid gives the eyes a relatively narrower and almond-like appearance.

The appearance of the turn occurs when the child looks right or left or turns their head slightly. As the child’s facial structure matures, more of the whites of the eyes are seen and the appearance of an eye-turn becomes less and often disappears.

It is still important to have a thorough assessment with an optometrist who has experience assessing young children, as you still need to make sure that a real eye-turn is not present. Age is not a barrier; infants as young as 6 months old can be assessed for the presence of an eye-turn and any risk factors that may contribute. Don’t feel that you are over-reacting as a parent as the optometrist can quickly determine whether an eye-turn is present and put your mind at ease. If an eye-turn is detected then it is great that it has been picked up so treatment can start early.

If no eye-turn is found, we recommended reassessment in the near future to confirm that indeed no eye turn is present.

How much do you know about childhood vision development? Test your knowledge!

How To Enhance Your Baby’s Eye And Visual Development

Key Takeaways

• Early visual development begins at birth and underpins eye-hand coordination, depth perception, and learning.

• Newborns focus best at 20–30 cm, making caregiver face interactions critical for early visual growth.

• Regular age-appropriate visual engagement (tracking, reaching, contrast play) supports healthy visual pathways.

• Paediatric optometry exams help detect vision delays before they affect developmental milestones.

• Early detection of problems like strabismus or amblyopia improves long-term visual outcomes.

Vision is our most precious sense, yet an infant’s vision is much less developed at birth than their other senses, such as smell. Therefore, it is vital that parents and caregivers provide the right environment to help their baby’s visual system to develop and mature. Many parents worry about motor development of their child, yet most don’t realise that there is also very important motor development occurring in the eye muscles too.

So, here are some tips for new parents, to promote your baby’s visual development:

The thing your baby will enjoy looking at most is your face. Hold your baby in front of you so they can watch your face as you talk or sing to them. Infants can typically only focus within 30cm. So ensure your face is close when talking to them.
Rotate how you lay your baby in their crib/cot regularly from one end to the other. This ensures they get equal visual stimulation on both sides of their body when they wake up. It is also advisable to swap their car seat to the opposite side of the car if you take regular car trips.
Hold your baby in front of your body as you talk to them, and rotate them slowly. From approximately three months old, your baby will begin to orientate themselves towards you and follow your face.
Ensure your baby has plenty of tummy time, and place objects for them to play with on both sides of their body. Lie next to them on the floor and talk or sing to them, and again, ensure you do this on both sides of their body. If your baby initially resists tummy time, DO NOT GIVE UP! Try tummy time with them lying on your stomach (whilst you lie on your back) so that they can lift their head and see your face.
Vestibular experience and stimulation is very important to early visual development. This is because the brain does a great deal of work to organise “what it sees” with “what it feels” to ensure it all matches up. The vestibular system comprises of the semi-circular ear canals and tells your baby’s body where it is oriented in space. As such, rolling and rocking your baby whilst maintaining eye contact is a great way to combine both visual and vestibular experience. Carrying your baby forward facing in a sling during awake time is also recommended.
If your baby has a favourite rocker or seat, ensure that you move the location of this rocker from time to time to take in a different perspective.
Movement is vital to your baby’s visual development. They learn to process and understand what they see in the world by moving through it . There is a saying we use in vision therapy a lot… “If it doesn’t get into the muscles, it doesn’t get into the brain!” A baby’s experience of the world was never meant to be static or still. Therefore, avoid television or other things that entertain your baby in a passive way.
When your baby begins using a highchair to eat, move their chair to different locations around the table or room. Again, this encourages varied and equal visual stimulation to both sides of the body.

When should I have my baby’s eyes checked?

Many people mistakenly assume that you cannot test someone’s eyes unless they can read a letter chart. This is definitely not the case! Early eye tests are not looking at a child’s sight (acuity on a letter chart), but rather at whether a child’s eyes are developing equally in the following ways:

does your baby have a full range of eye movements in all direction?
can your baby begin to fix and follow a target equally with both eyes?
is there any sign of an eye turn or lazy eye?
can your baby focus equally with both eyes?

Your baby’s first eye examination is recommended at between 6-9 months. After this time, we recommend further testing at 3 years old and at Prep. However, if you have any family history of eye turns or lazy eyes then you may be recommended checks more often. In addition if you have a family history of learning difficulties or attention problems (ADD/ADHD), you may also be recommended more regular reviews.

If you have any concerns about your baby’s visual development at any time, please contact our team immediately to discuss a consultation on 5520 5900.

How much do you know about children's visual development?

When Will My Baby’s Eyes Change Colour?

It shouldn’t be surprising that a baby’s eye colour is a very popular conversation topic with parents. “Most precious sense”, “windows to the soul”, and “the eyes have one language everywhere” are age-old quotes that indicate our long fascination with eyes.

So what causes eye colour? Generally light coloured irises are from an absence of pigment, where as a brown iris has pigment deposited on the surface. Many babies are already born with this pigment in place so the colour will not change. Any changes that do occur involve a darkening of eye colour over the first 12 months due to more pigment being deposited on the iris surface, with little change after this.

Classification by colour can be as simple as blue, green, hazel or brown. Or more complex like light blue, darker blue; blue with brown peripupillary ring, green, green with brown iris ring, peripheral green central brown, brown with some peripheral green, brown, and dark brown – phew! Classifying colour is one thing, predicting eye colour is another.

Eye colour is determined by our genes, with most models centring around blue vs brown. The simple blue-brown model has brown determined as the dominant colour and blue as a recessive colour. This means if you have brown eyes you can either have two dominant brown genes or one brown and one blue. Blue eyes can only happen when two blue genes occur together. So a baby is unlikely to be brown-eyed if both parents are blue. However it is possible for a child to be blue-eyed if both brown-eyed parents each carry the recessive blue gene. If you want to predict eye colour other than brown or blue, the genetic models are not so simple!

Should parents be concerned about eye colour? From an eye health perspective, significant changes in eye colour are rare after the first 12 months. Any changes to only one part of the iris or to one eye only can be signs of eye disease irrespective of age, so if you notice a change then it is worth having an assessment done. We recommend routine vision tests at 6 months, 3 years and annually for early primary school children.

Why You Can’t Use An iPod As A Babysitter!

I was shocked, yet not overly surprised recently to discover there are now devices that you can insert your iPhone or iPod into, to ensure that your baby does not wreck it whilst playing with it! Certainly, we cannot ignore the impact that small screen devices now play in our world. We communicate on them, we organise our lives on them, we socialise on them, and we can be entertained by them! But should we be allowing our children, toddlers and yes, even infants to play with them too?

Why is the real world so important?

Growing bodies are just that. Brains, muscles, bones and everything in between is developing. From my point of view, visual development requires one critical thing – interaction with the real world. Moving through space and interacting with real objects guides the development of depth perception, focusing, eye teaming, tracking and visual perception which are later critical for optimum performance in the classroom and for life. There is no short-circuiting this developmental route. It is not physically possible to get the same result from a game. Yes, gaming can improve your child’s hand-eye coordination – but predominantly just for games!

Risks to children

Research that provides an insight into the real impact of these devices on visual development is likely to be years away. There has been concerns raised about the impact of TV on development, we are concerned that personal devices may also have some negative impacts. Here are a few tips to for parents to consider:

Limit pre-school children and toddlers to 15 minutes per day on small screen devices;

Children between 6-9 yrs should limit their time to between 30mins to 1hr a day;

Older children should limit their time playing on small screen devices, and ensure they take regular breaks every 15-20minutes. This is because their world requires them to make use of so many other screen-based devices such as computers, that it is important to have some visual rest from close viewing. To reduce the risk of short-sight, research shows they should regularly spend time outdoors looking far into the distance;

Parents should also limit their time playing on devices, in order to spend quality time communicating and interacting with children. Children develop their ability to process language, which importantly includes body language by participating in two-way conversations.

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