Newborn babies are sweet, cuddly and require daily care to keep them happy and healthy. One of those areas of their health that must be addressed is newborn eye care. Babies cant tell you if they have eye or vision problems, if they are itchy or swollen. So physicians and parents should be diligent about their care of a baby’s eyes.
Babies usually keep their eyes shut for long periods of time but they can react to lighting changes. They typically focus on objects that are within 1 foot of their faces and are most interested in faces. Their mothers face is usually their first visual cue in the first couple of months. Their vision which starts at about 20/400 rapidly improves to 20/20 by the time they are 2 or 3 years old.
To help prevent infections in the eyes of newborns physicians use antibiotic eye drops and ointments. These can cause swollen eyelids for a short time and sometimes a chemical conjunctivitis, which is an inflammation of the membrane that lines the eyelids. This condition can cause a yellow discharge from the eyes and swollen lids.
Eye coloring may change after birth to its permanent color at about 6 months of age.
The whole process of childbirth is difficult for both the mother and the child. Because of the pressure exerted on the babys body to remove fluid from the lungs, making the first several hours after birth much healthier for the newborn, the eyes can also have small hemorrhages, or blood spots, in the whites of the eyes. These spots typically spontaneously disappear after 2 or 3 weeks.
Infant blocked tear ducts are another common problem for newborns. These blocked tear ducts are often caused by a thin membrane that hasn’t ruptured after birth that closes the duct. The tear gland (lacrimal gland) continues to produce tears that flood the eye and drip over onto the baby’s cheek because the duct, which normally helps remove the tears, is blocked.
New parents may think that the newborn has conjunctivitis because the dried tears often have a yellowish tint and look infected. The physician will show the parents how to do a gentle massage over the area to help break up the membrane and allow the tears to drain naturally through the duct. Even if the duct isn’t opened through massage it usually opens as the baby grows by the time they are 1 year.
Believe it or not the baby will have their first eye exam before they leave the hospital. This first exam doesn’t require the participation of the baby but rather involves the doctor looking for signs or physical symptoms that the child has difficulty with their sight. They will look at reflexes, shape of the eye, movement of the eye ball and for swelling and discharge that may not be expected. If problems are detected they will refer the child to an ophthalmologist after discharge.
There are warning signs that a newborn or infant is having trouble with their sight and parents should call their pediatrician immediately if they notice any of these signs:
- Uncoordinated movements after the baby is 3 months
- Eyes that appear to be looking downward
- Cloudy areas of the eyes
- Eyes that tear daily
- Dark yellow discharge from the eyes
- Red or swollen eye lids
- Pus that sticks the eyelids together
- Whites of the eyes that are red or pink
Routine eye examinations and newborn eye care is important to find problems early, prevent problems or start early treatment for issues that may result in permanent loss of sight.
When the infant comes home a daily cleaning of the eye area, without soap, is essential to good daily hygiene. Using a cotton ball or the edge of a soft washcloth that is wet with warm water sweep the eye from the inner corner near the nose to the outer corner. Look at the eyes carefully for anything that appears abnormal and report it to your doctor as soon as possible.
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