Planned eye check-ups for newborns include a mandatory examination by an ophthalmologist immediately after birth, especially in premature births. The doctor assesses the correct formation of the ocular structures, the transparency of the media, the absence of congenital cataract (clouding of the lens) or corneal clouding, the size of the eyeball and the absence of increased intraocular pressure. Congenital cataracts and congenital glaucoma require emergency surgical treatment to preserve visual acuity and proper development of the eye as a visual organ.
The eyelid structure and the presence of inflammation are also assessed. If the baby’s mother is a carrier of a dangerous infectious disease or if the pregnancy was complicated, these issues can affect the baby’s eye health.
In the case of prematurity, it is essential to rule out incomplete vascularization of the retina, i.e. the blood vessels have not reached the end of the eye, and there is a risk of developing retinopathy of prematurity. This condition is dangerous because in areas without blood vessels, factors are produced that stimulate the growth of new, fragile-walled vessels that are prone to bleeding. This can lead to vision loss. It is vital that the diagnosis is established early and laser treatment of areas without vessels or injections of drugs that inhibit the growth of abnormal vessels are performed.
1 month review
At the age of 1 month, an ophthalmologic check-up is recommended to check the patency of the nasolacrimal duct, which connects the eye to the nasal sinuses. Normally, the duct starts to work with the first cry of the newborn, and the tears drain freely into the nose. However, in some children, the presence of membranes or adhesions in the tear duct can cause stagnation of tears, leading to chronic inflammation manifested by purulent discharge, redness, pain and photophobia.
Tear sac massage is recommended as a first step. If the 10-day massage is not effective, a tear duct probe is indicated. In most cases, a single intervention solves the problem, but sometimes repeated interventions are needed.
Examination at 3 months and over
From the age of 3 months, children can fixate and hold their gaze long enough to allow measurement of ocular refraction using an autorefractometer. Nowadays, there are special models for children with visual and sound effects, turning the exam into a fun game. Autorefractometry allows the assessment of objective eye refraction in children who cannot yet speak. At birth, the child’s eye is small and farsighted. As the child grows, the eye reaches near adult size around the age of 7. It is important that this process is gradual, and that a slight hyperopia (+0.75 diopters) remains at age 7. Children whose eyes grow too fast are at risk of nearsightedness and need close monitoring, especially if one or both parents are nearsighted.
This makes it possible to identify the right time for preventive measures, such as strictly limiting up-close activities, increasing time spent outdoors in natural daylight or prescribing glasses to ensure normal eye development.
