GUIDE TO VISION DEVELOPMENT

Children's vision plays a critical role in their development, ability to learn and overall health

Children's vision plays a critical role in their development, ability to learn and overall health. Research shows that approximately 75% of what children learn during the early years of life is processed through their visual system. Learning to see is a complex constantly evolving learned skill that depends on appropriate stimulation and experience in order for children to reach the fundamental milestones for interpreting, understanding and interacting with the world around them. Visual development begins in the womb and continues throughout childhood and adolescence. At birth, the visual system is still immature, and the development of a mature visual system is especially critical within the first six years of life.

Having a basic timeline for vision development helps parents know what to expect at different ages while being able to enjoy their child's development. However, they need to remember that each child is unique, and each child reaches developmental milestones at their own individual pace. A timeline is simply an age-related guide that may assist parents with stimulating their children and alerting them to any problems that the child may experience.

At birth, an infant is very sensitive to bright light, and the pupils remain small, limiting the amount of light entering the eyes. Within a couple of weeks, as the retinas develop, the pupils begin to widen. Newborns see in black and white. By one month of age, the baby may focus briefly on faces but is more attracted by large shapes and bright colours. Although his eye movements are uncoordinated, so that he appears cross-eyed, he is beginning to make eye contact. By six weeks, he recognises a smile and soon responds with a smile of his own. Although infants cry, the lacrimal glands only begin to produce tears at about two weeks and visible tears are shed by the end of the first month.

From 2 to 4 months the eyes are able to work together and independently of the head as focusing and tracking moving objects begins to be refined. It is normal for the eyes to appear crossed or seem to wander at times and this will usually correct itself but should be investigated if it persists beyond this stage. As eye-hand coordination develops, the baby will reach for objects and spend time intently watching his moving hands. He holds eye contact for longer and is fascinated by facial expressions, even trying to imitate them.

Between 5 and 8 months the baby is seeing the world more completely in three dimensions and depth perception is improving with him being able to judge how far away an object is. He recognises familiar people and objects and is becoming better at reaching for them. He enjoys looking at himself in the mirror. Although not quite as fully developed as an adult's, colour vision is developing and he may even show a preference for certain colours.

Babies generally start crawling at around 8 to 9 months old, and this further strengthens their eye-hand coordination and their visual perception as they explore their world. Rapid learning occurs in all areas of development as they move around freely. By 12 to 15 months, they are pulling themselves up to stand and trying to walk. They are able to judge distance well and will crawl to reach distant objects. Peek-a-boo becomes a favourite game.

Toddlers aged between one and two years are honing their visual-motor skills as their gross and fine motor coordination improves. They are able to throw, roll and kick a ball with a degree of accuracy. While not yet able to hold a crayon correctly, the toddler enjoys scribbling and begins to attempt to draw different shapes. His ability to discriminate shapes and colours improves. He has clear distance vision and his depth perception continues to become refined. He enjoys books, recognising images of familiar objects and focusing on pictures that are of interest to him.

During his preschool years, the child continues to develop and he begins to acquire pre-reading and pre-writing skills. He is able to change focus easily for various distances, recognise and name shapes and colours, perceive differences and similarities between shapes and colours, draw certain shapes and even begin to write letters of the alphabet fairly accurately. His confidence and skill in the area of motor coordination grow.

By the time he enters school, the child's visual perceptual skills should be sufficiently developed for the demands of learning in the classroom. A large percentage of schoolwork relies on vision and visual abilities. He should have a clear and comfortable vision for all distances and be able to change focus from close to distance quickly and efficiently. To facilitate success and confidence at school, the child should display competent visual perceptual skills, including visual association, visual discrimination, visual memory, visual sequencing, and hand-eye coordination.

Children's vision continues to develop and change throughout their entire life, from infancy, through middle childhood and into adolescence. Physical changes during puberty can affect the eyes, resulting in vision changes, but the child may not be aware of the shift in vision. Teenagers experience lifestyle changes that impact on vision, including extended screen time leading to digital eye strain, more outdoor activities which exposes them to increased UV rays, and sports that may increase injury risks. It is important for them to have regular eye examinations to monitor any changes in their vision.

Parents play a vital role in the healthy development of their child's vision. They need to involve their children in age-appropriate activities which will stimulate visual development. Children, and even adolescents, are unaware that they are seeing or not seeing what others see, and do not have the maturity to express or communicate a problem. It is up to the parents to be vigilant, watch for warning signs of problems and schedule an appointment for an eye examination. The sooner a vision problem is diagnosed and treated, the sooner it can be corrected. Vision issues that are left undetected or untreated can lead to unnecessary learning problems, confidence issues, frustration, and an overall disinterest in certain social and learning activities.