By Namita Jacob
Listed below is the normal visual development sequence of a child.
Is your child deviating from this sequence?
Age: Birth to 1 month
Child stares at large bright objects such as open windows and doorways, and blinks when light is too bright.
Visual behaviour: Looks at faces and objects in field of vision briefly. Pupils constrict when light is shone into the eyes, dilate when light is removed (pupillary response).
Visual testing: Eyes turn the opposite direction that head turns. This response should be inhibited after the first few weeks as fixation ability increases (Doll’s eye
Age: 1 – 3 months
Child stares at objects within field of vision. Looks at faces and features with attention. Looks at high contrast patterns such as stripes and geometric shapes.
Visual behaviour: Eyes may not always work together or remain straight. Follows a slowly moving object horizontally from center to side and side to center (can not cross midline). Able to shift gaze between objects and visually scan to locate objects or people in the environment. By three months, Doll’s eye no longer present, steady fixation present.
Visual testing: Starts to display convergence, that is, can focus on an object from 5 inches to 3 inches distance from the eyes.
Age: 3 – 5 months
Child recognises and responds to mother's face and watches objects as they move out of sight in all directions.
Visual behaviour: Recognises and visually searches for familiar toys/objects. Crosses midline, able to follow more quickly and smoothly. Should be able to follow object moving vertically as well as horizontally.
Visual testing: Able to judge speed of moving object.
Age: 5 – 7 months
Child looks at and responds to a variety of facial expressions, and is interested in picture books.
Visual behaviour: Enjoys “finding” objects hidden in front of them. Test for binocularity, any deviations with one eye turning out or in, up or down, should be referred if seen at 6 months or later.
Visual testing: Notice eye position at rest and while focusing on an object. Cover one eye, get the child to attend to you and then uncover the eye. If the covered eye
moves, then refer for phoria.
Age: 7 – 12 months
Child Imitates facial expressions and is interested in and picks up small objects.
Visual behaviour: Looks for objects in other objects.
Visual testing: Shows smooth visual pursuit – can use eyes alone to follow moving