Strabismus in children. Treatment of strabismus. Eye gymnastics

There are two established points of view in society about strabismus: the first implies that it cannot be treated at all, and the second - that it goes away on its own without the participation of a doctor. Both opinions are fundamentally wrong – how before parents turn to a specialist, the faster and more successful the baby’s recovery from this illness will be. Strabismus in a newborn child is not only cosmetic defect. It affects mental and mental development.

When does strabismus go away in newborns? What should I do and which doctor should I contact if my child’s eyes start to squint? Is it possible to cure the disease completely?

Why do babies cross their eyes?

Strabismus, or strabismus, is a disorder of the eye muscles, in which the child is unable to focus on an object with both eyes. Normally, both eyes, left and right, move symmetrically. With strabismus, the central axis is shifted, the pupils look into different sides. At the same time, the brain is not able to combine what it sees with different eyes images into one.

Strabismus is common in newborn children - it affects 2 children out of 100. Every parent can independently identify the pathology - strabismus is noticeable to the naked eye. Some children suffering from this condition are already born with one or two slanted eyes.

Strabismus in newborns can develop in the womb or at birth and occurs for the following reasons:

consequences of difficult childbirth;
infectious diseases of the mother during pregnancy;
maternal use of certain medications or drugs;
genetic diseases, such as Down syndrome;
hereditary predisposition;
congenital defects of the eye structure;
birth of a child prematurely;
hydrocephalus.

There are a number unfavorable factors, due to which strabismus occurs in the first days of a baby’s life

During life, strabismus develops for the following reasons:

visual impairment, farsightedness and myopia - the child tries to focus his gaze on an object and strains his eyes very much;
diseases and abnormalities of the eye muscles;
inflammation of visual structures;
consequences infectious disease(measles, scarlet fever, influenza);
eye damage, traumatic brain injury;
stress and strong psycho-emotional states;
strong visual stress;
pathologies of the nervous system.

Types and symptoms of strabismus

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

According to the time of occurrence, strabismus is divided into congenital (occurs infrequently) and acquired (forms by 1-3 years of a child’s life). Strabismus also occurs:

constant - this is the most common species, it is diagnosed in 75-80% of cases;
periodic - occurs in certain situations, for example, during illness or stress.

Periodic strabismus sometimes develops over time permanent form. If a child has one eye squint, this is monolateral strabismus; if both eyes squint, it is alternating.

The pupils can diverge in different directions:

converging to the nose - esotropia;
diverging to the temples – exotropia;
vertical deviation - up or down;
mixed type.

In addition, pathology can be true and imaginary. A newborn baby is simply not yet able to focus his gaze, while he perceives the entire visual image - this is imaginary strabismus. With true strabismus, the picture appears double or distorted.

Symptoms inherent in strabismus:

the child tilts his head and squints when looking at or trying to focus on an object;
the baby does not perceive the depth of space and may bump into something when walking;
fuzzy, blurry image, doubling of objects;
pain in the head and eyes;
dizziness;
the child cannot look at the light.

With strabismus, the baby often squints and finds it difficult to look at bright light

Some of these signs are always present. Others appear with strong stressful situations, fatigue or illness.

Diagnosis of pathology

As a rule, there are no problems with making a diagnosis, since the defect is quite noticeable. Strabismus is diagnosed based on a visual assessment by an ophthalmologist, who will determine why the baby has one or both eyes slanted:

Already at the first visit, at 3 months, the doctor will be able to determine visual impairment using ophthalmoscopy and measure the angle of deviation of the image on the pupil.
Skiascopy will help find out how the eye refracts light rays, and whether there is functional disorders. By 6 months, signs of strabismus should disappear.
The eye-covering test reveals hidden strabismus. It is carried out at the age of 1 year. One eye is closed, and the baby is asked to follow the object with the other. Deviation to the side indicates the presence of strabismus.
At 3 years of age, a special color test. It will help determine if there are any violations binocular vision.
Examination with a special apparatus - a synoptophore. By influencing the baby's eyes, the angle of deviation of the pupil from the healthy position is measured.

An ophthalmologist diagnoses strabismus during a visual examination of a baby

Strabismus correction

Treatment depends on the cause of strabismus and the extent of the damage. visual organ. If necessary, a pediatric neurologist will be involved in therapy. If the pathology is serious, it will be treated in a hospital. In other cases, outpatient and home treatment is provided.

Treatment of strabismus must begin immediately, since vision is significantly affected as the disease progresses. Only the doctor decides which therapy is suitable for a particular child.

Treatment methods used to correct strabismus:

An occluder is a special shutter that is placed on the healthy eye (for unilateral strabismus) or on both in turn (for bilateral strabismus). As the load increases, the diseased organ begins to see better.
Wearing special glasses - when the cause is visual impairment (farsightedness, myopia or astigmatism), wearing glasses completely eliminates this defect.
Special eye drops. They temporarily impair the visual function of the healthy eye, forcing the affected eye to work harder.
Amblyocor is a device that helps brain neurons correctly interpret the picture and eliminates the “lazy eye” syndrome.
Synoptophore - trains the eyes and restores binocular vision.

Synoptophore eye exercises are effective for strabismus.

Amblyopanorama is a device that improves visual acuity.
Exercises for the eyes. They eliminate strabismus initial stage with minor damage to the visual organ and strengthen the muscles of the eye.
Surgical intervention. It is performed for children over 3 years of age and is indicated in cases where the above conservative treatment does not bring results. For children, safe mild anesthesia is used. The surgeon will adjust the eye muscles so that they work normally.

The prognosis is favorable if treatment is started in a timely manner and all the specialist’s instructions are followed - children stop squinting with one or both eyes. In most cases, visual function can be restored, the main thing is not to progress the disease.

When does strabismus go away in infants?

The visual system of a baby after birth and up to 3-4 years is unstable, since it is at the stage of formation. Its pathologies can be provoked by seemingly ordinary things, for example, watching TV, playing games. mobile phone or a toy hung too low in the cradle. That is why at this age special attention should be paid to the prevention of strabismus.

All babies under 2-3 months cannot yet focus their gaze on an object, so a slight deviation at this age is not scary and is a variant of the norm. By 3-6 months this phenomenon disappears.

However, wait until the squint will go away in a newborn, it’s not worth it - it’s better to play it safe and consult a specialist for advice.

True strabismus develops at 2-3 years, when it improves collaboration eye. It can be diagnosed by the child's incorrect head tilt and wandering gaze. However, in some cases, strabismus converging to the bridge of the nose can go away on its own, even if it appears in children over 2 years of age.

Prevention

To prevent strabismus in a newborn and older child, you need to:

visit regularly during pregnancy antenatal clinic and undergo all necessary studies;
mothers should not take medicines, not intended for pregnant women, much less drinking alcohol or using drugs;
for correct and timely diagnosis, you need to regularly take your baby to a pediatric ophthalmologist;
You cannot hang bright toys above the crib - the baby will concentrate his gaze on one point;
rattles should be placed at arm's length for the child;
You should start watching television programs no earlier than 3 years old, and play and study on the computer no earlier than 8 years old;
you should pay attention to the child’s posture, teach him to sit correctly, with a straight back;
in the family you need to create a favorable psychological climate- avoid quarrels and conflicts, do not expose the baby to stress.

The first year of a baby's life is considered the most interesting time, you watch how his arms grow, how his tiny body changes and grows stronger. But besides the obvious external signs, the child’s senses also change, primarily the eyes.

Path of formation visual system baby is one of the most complex processes. Newborns have less than twice as much vision as an adult! In this case, the eyes begin to develop already in the third week of the fetus’ life. Up to three months, a child can see at a distance of only 40-50 centimeters, for him this is quite enough to see the breasts and face of a nursing mother.

Why do my eyes cross...

During the first weeks, the baby’s eyes “wander,” which gives the impression that the child is slightly squinting. In fact, this is due to the fact that in the first weeks all babies are farsighted; the eyeball of a newborn is much smaller than that of an adult. The cause of infantile “squint” can also be undeveloped facial features, for example, an overly large bridge of the nose. In a few weeks, when the nose begins to grow, the proportions will correct. At first, the baby may squint, or rather, move his eyes to the bridge of his nose, looking at some objects close up. Over time physiological characteristics will return to normal, and the squint will go away on its own.

The doctor knows best

Only an ophthalmologist can really determine whether a child has problems. Routine examinations with a doctor take place in the first month, at six months and at the year. At the first examination, the doctor determines whether the baby can fix his gaze, examines the eyelids, tear ducts, mucous membranes of the eye and checks the transparency of the cornea. In the first week of life, it is usually not completely transparent due to slight swelling. At six months, the doctor can already detect strabismus, farsightedness or myopia.

If you suddenly have any suspicions about problems with the eyes, take your baby to an ophthalmologist; it’s better to double-check than to cause the disease to worsen. Do not forget about heredity; if one of the parents in the family has vision problems, check the baby more often and do not forget to warn the doctor about this. Correcting vision is much easier in still early age. One of my friends, having poor eyesight, was sure that her daughter had perfect vision until she went to school. The problems became noticeable only when the girl, one of the best students, began copying assignments from the board with errors. The child had to put on glasses, and the ophthalmologist was indignant that the mother brought her daughter in too late. At this stage, vision could only be restored through surgery.

Be sure to go to the doctor if you notice that your child:
- eyes often turn red,
- discharge appears in the corners,
- strabismus does not disappear within several months,
- the eyes make frequent (rhythmic) beacon-like oscillations (nystagmus).

Sometimes babies experience dacryocystitis - inflammation of the lacrimal sac, which is located between the nose and the inner corner of the eyelids. This happens due to the underdevelopment of the lacrimal ducts in children. It happens that the membrane, which closes the duct of the nasolacrimal duct during the intrauterine development of the child, does not disappear after birth on its own. You can get rid of it within a week with the help of massage.

If something gets into the eyes, do not under any circumstances try to wash them, which is called the “old fashioned way” - breast milk or saliva. Contact a doctor or call an ambulance immediately.

Helping the eyes

From three months, the child’s vision improves significantly; he can already focus his gaze on objects and even pick them up. But it is recommended to develop vision in babies from the first month. For this purpose there are absolutely simple ways:

— The crib should be in the brightest room, it is advisable that the lighting be combined - daylight and electric, the light will force the eye muscles to move. But this does not mean that there should be bright lighting there around the clock. It is advisable to have a night light with a dimmer in the room.
- It is better to decorate the room in pastel colors - beige, peach, light green, light blue, soft pink are perfect for this. Do not irritate your child with poisonous bright colors.
- The toys that you hang above the crib should be at a distance of about 30 centimeters and have different shapes and color. Preferably blue, green, yellow, blue colors.
- Do not accustom your child to watching TV. This bright machine with constantly changing pictures and colors puts an extra strain on the child’s vision.

After 12 months, the child not only sees, he is able to perceive the gestures of an adult and begins to copy them, for example, waving his hand goodbye. But only after three years, a child’s vision becomes almost the same as that of an adult.

Katya Fedorova

A newborn baby is no different good eyesight, and sometimes he completely shocks his parents because his eyes squint, cannot focus, they are clouded. Questions about whether the child is healthy and whether he can see are quite common reasons for visiting pediatricians. In this article we will tell you what the features of visual function are in babies of the first year of life and how to determine whether the baby can see.

Peculiarities

The baby sees the world around him completely differently from adults. This is easy to explain first of all physiological reasons- a child’s eyes differ significantly in structure from the eyes of an adult. Children are not born with visual organs that are fully adapted to this world and sufficiently formed. All babies, without exception, have extremely low visual acuity in the 1st month of life. Everything that for us is a picture of the surrounding world, for a newborn is a set of spots of different illumination and intensity. His eyes are in a continuous process of formation.

The eyeballs of a newborn are much smaller in proportion than the eyeballs of an adult, and therefore the baby receives the image not on the retina, but in the space behind it.

This explains why all infants suffer from physiological farsightedness, which is completely normal for them. In the first days, the baby does not focus his gaze at all. Sees mostly black and white spots, only outlines and at an average distance - about 40 centimeters. But he perfectly distinguishes between light and darkness. In response to a bright source of light, the baby may begin to blink, close his eyes, try to cover himself with his hand, shudder with his whole body, and the baby may react to a too harsh and bright light with a dissatisfied, angry cry. These reflexes are called unconditioned visual. They must be checked in the maternity hospital.

There is a myth that a newborn's vision is upside down. This is not true. If there are no brain pathologies, gross birth defects of its development, the baby sees it in the same way as all other people. An inverted image is not typical for infants.

But many completely healthy babies who were born just a couple of months ago are characterized by a wide variety of eye movements, which parents sometimes mistake for strabismus, nystagmus, and other signs. poor eyesight. In fact, newborns and infants have very weak eye muscles, and therefore it is not surprising that one eye of the baby is looking at you, and the other is slightly to the side. This is a temporary phenomenon, which, with the normal development of visual analyzers, will disappear on its own in a fairly short time.

In the first three years of life, the baby’s visual organs undergo enormous dramatic changes. This process requires a reverent attitude on the part of adults, the elimination of all negative factors due to which vision problems can develop. To act correctly, mothers and fathers need to know what processes occur and at what stages of development; this will help maintain the child’s health and notice deviations in time if they occur.

Stages of development

The eyes of the embryo begin to form at 8-10 weeks of pregnancy. It is important that at this moment the mother is healthy, and no negative factors did not affect the correct formation of the visual organs, optic nerve. Pathologies that arise during the period of stay in the womb are quite difficult to correct, if they can be corrected at all.

In the mother’s belly, the baby distinguishes between light and darkness, demonstrates unconditioned visual reflexes, but he does not see bright light, getting used to a darkened and dim atmosphere. After birth, the toddler needs to adapt to its new living conditions. The baby begins to distinguish something other than light at about 3 weeks after birth. It is at this stage that object and color vision begins to form.

By the beginning of the second month independent life The baby can already hold his gaze for a very short time at large bright and large objects located at a distance of no more than 60 cm from him. By 3 months, the baby is able to follow a silent toy with his eyes for much longer. Moreover, the toy itself can now move left and right and up and down. The child repeats similar movements with his eyeballs, turns his head towards a bright object of interest to him.

By six months, children develop stereoscopic vision. The baby has no problems focusing on objects, following them with his eyes, and can reach out and take toys in his hands.

Color perception is formed gradually - first, babies begin to distinguish the color red and give preference to it. Then they see yellow. Green and blue are the last to be comprehended and realized.

After 6 months, toddlers learn to see distant spaces. Stereoscopic vision allows them to see the world in a three-dimensional, full-fledged way, and the improving capabilities of the body (it learns to sit, crawl, walk) gradually stimulate the development of the cortical part of the brain, which is also responsible for the accumulation of visual images. The baby learns to estimate the distance between objects and overcome it; the color scheme also becomes more saturated in the second half of life.

Congenital physiological farsightedness, characteristic of all infants, usually disappears by 3 years. During this time, children's eyeballs actively grow, the eye muscles and optic nerve develop and improve. A child’s visual organs become as similar as possible to adults only by the age of 6-7 years.

None age stage the child no longer experiences such dramatic changes and transformations in the organs of vision as in the first year of life.

Surveys

Children undergo their first examination by a neonatologist in the maternity hospital. It allows you to a large share accurately identify most congenital pathologies of the visual organs. These include neonatal retinopathy, congenital cataracts and glaucoma, optic atrophy and other visual ailments. Serious congenital pathologies are often accompanied by manifestations of such external signs as nystagmus (twitching and twitching of the pupils) and ptosis (drooping of the eyelid). However, an examination in a maternity hospital cannot be considered 100% reliable, since many diseases, including those inherited genetically, develop only over time.

That is why it is so important that infants, especially premature ones, are promptly examined by an ophthalmologist. The first examination always occurs at the age of 1 month. At this age, the doctor is limited to assessing visual reflexes, including a light test on the pupil, as well as a general examination of the eyes - shape and size eyeballs, pupils, purity (clearness) of the lens.

The next check for premature babies is planned to be at 3 months, and then at six months. For babies born on time, one check every 6 months is sufficient.

At six months, the doctor will be able to get a more detailed idea of the baby’s visual function. He will not only visually assess the condition of the eyes using instruments, but also check them motor activity, focusing on objects, synchrony of reaction, accommodation and refraction. The doctor will tell the parents of a six-month-old child with a high degree of accuracy whether their child’s slight strabismus is functional and harmless or is it pathological change which needs correction.

If parents have doubts that the child sees well, the doctor may try to examine the baby’s vision using a special tablet. One half of the sheet is covered with black and white stripes, the second is white. The mother closes one of the baby’s eyes, and the doctor brings this piece of paper to his face. If the baby automatically begins to look at the striped part of the table, then he sees, and there is no reason to worry.

An ophthalmologist can conduct the same study at the next scheduled inspection which must be completed in 1 year. After one and a half years, Orlova’s diagnostic table is used to assess visual acuity; if any disorders are detected, the degree and severity of the problem is checked using special techniques and devices. After one and a half years, it is recommended to check your child’s vision twice a year.

How to check it yourself?

Check your newborn's vision independently at home and infant quite difficult. However, there are symptoms that parents must pay attention to and consult a doctor as early as possible, who will help carry out a full and detailed examination at the clinic:

The child was born into a family where close relatives have vision problems. With a high degree of probability, the baby will inherit the pathology; he should be observed by an ophthalmologist as often as possible.
The child was born premature.
At 1 month the baby does not react by constricting the pupil, if you shine a flashlight in his face.
After 3 months the baby does not focus on bright big toys, reacts only to “sounding” rattles and squeakers, not noticing toys and objects that do not make any sounds.

At the age of 4 months does not follow the toy, which is moving.
At the age of 5-7 months, the baby does not recognize the faces of his family and does not distinguish them from persons strangers, does not reach for toys, does not try to grab them with his hands.
If purulent or other discharge appears from the organs of vision.
If the child's eyeballs are different sizes.

If the pupils move up and down involuntarily or from side to side, shaking slightly.
If the baby noticeably “squints” with one eye.
By the age of one year, the child does not pay attention to birds on the street, to other fairly distant objects.

All these signs cannot independently speak about possible pathology visual analyzers, but are a very convincing reason to visit an ophthalmologist unscheduled.

Development

The anatomical and physiological features of vision development in children of the first year of life (AFO) will tell parents what and how to do in order to promote the development of the baby’s visual function. If the baby was brought from the maternity hospital and placed in a darkened room where there is little sunlight, then all stages of vision formation may occur with a significant delay. For newborns, it is very important that the room is bright, so that there are no bright sources of light or mirrors near the crib. Access to the crib should be from all sides so that the baby gets used to looking at people and objects on both the right and left sides.

In the first days and even weeks, the child does not need any toys, since he will not really see them anyway. But by the 3-4th week of life, you can attach a mobile to the crib or hang rattles. The main requirement that will help maintain the health of your baby’s eyes is the distance from the face to the toy. It should not be less than 40 centimeters.

For the development of visual function, it will even be useful if the toy or mobile is raised from the baby’s face at a distance of 50-60 centimeters.

From one and a half months, the child can be shown black and white pictures, consisting of simple geometric elements. They can be found on the Internet and printed on sheets of A4 format. Such simple activities contribute to the development of the optic nerve and eye muscles, and the child learns to perceive contrasting images.

Infants' eyes often squint rather cutely. And there’s nothing wrong with that – at first glance. Moreover, it touches the parents. However, several months pass, the child grows, and his eyes continue to squint, which cannot but alert adults. With suspicions of strabismus, parents most often turn to ophthalmologists. This is the most popular reason for an unscheduled visit to a pediatric ophthalmologist. You will learn about the causes and treatment of strabismus in children by reading this article.

What is it?

The disease, which is popularly called strabismus, in medicine has quite complex names - strabismus or heterotropia. This is a pathology of the visual organs in which the visual axes cannot be directed towards the object in question. Eyes with differently located corneas cannot be focused at the same spatial point.

Quite often, strabismus is found in newborns and children in the first six months of life. However, in most cases, such strabismus is physiological in nature and goes away on its own after a few months. Often the disease is first detected at the age of 2.5-3 years, since at this time the work of children’s visual analyzers is actively developing.

Normally, the visual axes should be parallel. Both eyes should look at the same point. With strabismus, an incorrect picture is formed, and the child’s brain gradually “gets used to” perceiving the image from only one eye, the axis of which is not curved. If you do not provide your child with timely medical care, the second eye will begin to lose visual acuity.

Strabismus often accompanies eye diseases. More often it occurs as a concomitant diagnosis with farsightedness or astigmatism. Less often - with myopia.

Strabismus is not only external disadvantage, a cosmetic defect, the disease affects the functioning of all components of the organs of vision and the visual center.

Causes

In newborns (especially premature) children, strabismus is caused by weakness of the eye muscles and optic nerve. Sometimes such a defect is almost invisible, and sometimes it catches your eye right away. As all parts of the visual analyzers actively grow, physiological strabismus disappears. This usually happens around six months or a little later.

This does not mean at all that parents of a six-month-old baby who squints his eyes need to sound the alarm and run to the doctors. It is, of course, worth visiting a doctor, but only to make sure that the child does not have other vision pathologies. If the baby sees well, then strabismus continues to be considered physiological until he reaches one year old.

Strabismus, which persists to one degree or another after a year, is not considered the norm, and is classified as a pathological disorder. There can be many reasons for the occurrence of pathological strabismus:

Genetic predisposition. If close relatives of the child or his parents have strabismus or had it in childhood.
Other diseases of the organs of vision. In this case, strabismus acts as an additional complication.
Neurological diseases. In this case, we can talk about dysfunction in the activity of the brain in general and the subcortex in particular.
Skull injuries, including birth injuries. Typically, such strabismus occurs as a result of acquired problems in the central nervous system.
Congenital factors. These include intrauterine malformations of the visual organs, which could have formed as a result of infectious diseases of the mother or genetic “errors,” as well as as a consequence of fetal hypoxia.
Negative external influence. These reasons include severe stress, fright, psychological trauma, as well as poisoning toxic substances, chemicals or severe acute infectious diseases(measles, diphtheria and others).

There are no universal reasons that can explain the occurrence of pathology in a particular child. Usually this is a complex various factors– both hereditary and individual.

That is why the occurrence of strabismus in each specific child is considered by the doctor on an individual basis. Treatment of this disease is also purely individual.

Symptoms and signs

Signs of strabismus may be visible to the naked eye, or they may be hidden. One eye or both may squint. The eyes may converge toward the nose or be “floating.” In children with a wide bridge of the nose, parents may suspect strabismus, but in fact there may not be any pathology, just anatomical features the structure of the child's face will create such an illusion. As they grow (during the first year of life), this phenomenon disappears.

Symptoms of strabismus usually look like this:

in bright light the child begins to “squint” more strongly;
the baby is unable to focus his gaze on an object so that the pupils move synchronously and are in the same position in relation to the corners of the eyes;
to look at an object with a squinting eye, the child has to turn his head at an unusual angle;
While crawling and walking, the baby bumps into objects - especially if they are located on the side of the squinting eye.

Children older than one year may have complaints about headache, frequent fatigue. Vision with strabismus does not allow you to see the picture clearly; it may be blurry or double.

Children with strabismus often experience increased sensitivity to the light.

Strabismus can be congenital or acquired. ABOUT congenital pathology doctors say when obvious signs illnesses are visible immediately after the birth of the baby (or appear during the first six months).

Usually the pathology develops horizontally. If you mentally draw a straight line between the pupils across the bridge of the nose, then the mechanism for the occurrence of such a violation of visual function becomes clear. If the child’s eyes seem to be moving towards each other along this straight line, this indicates convergent squint. If they move in different directions in a straight line, then this is divergent strabismus.

Less commonly, pathology develops vertically. In this case, one or both organs of vision may deviate upward or downward. Such a vertical “departure” upward is called hypertropia, and downward - hypotropia.

Monocular

If only one eye deviates from the normal visual axis, then they speak of a monocular disorder. With it, the vision of the squinting eye is reduced in most cases, and sometimes the eye completely ceases to participate in the process of looking and recognizing visual images. The brain “reads” information from only one healthy eye, and “turns it off” as it is not needed.

This pathology is quite difficult to treat, and the functions of the affected eye cannot always be restored. However, it is almost always possible to return the eye itself to its normal position, thereby eliminating the cosmetic defect.

Alternating

Alternating strabismus is a diagnosis that is made if both eyes squint, but not at the same time, but in turn. Either the right or the left organ of vision can change the axis both horizontally and vertically, but the angle and magnitude of deviation from the straight line are always approximately the same. This condition is easier to treat, since both eyes still take part in the process of perceiving images of the surrounding world, albeit alternately, which means that their functions are not lost.

Paralytic

Depending on the reasons that triggered the formation of strabismus, there are two main types of strabismus: paralytic and friendly. With paralysis, as the name implies, paralysis occurs of one or more muscles responsible for eye movement. Immobility can be a consequence of disorders of the brain and nervous activity.

Friendly

Concomitant strabismus is the simplest and most common form of pathology, which is usually characteristic of children's age. The eyeballs retain full or almost full range of motion, there are no signs of paralysis or paresis, both eyes see and are actively involved, the child’s image is not blurry or double. A squinting eye may see slightly worse.

Concomitant strabismus can be accommodative and non-accommodative, as well as partial. Accommodative pathology usually appears in early childhood- up to a year or 2-3 years. It is usually associated with high or significant myopia, farsightedness, and astigmatism. Such a “childhood” eye disorder is usually treated quite simply - by wearing glasses prescribed by a doctor and sessions of hardware therapy.

Partial or non-accommodative visual impairment also appears at an early age. However, myopia and farsightedness will not be the main and only reasons for the development of these types of strabismus. Surgical methods are often chosen for treatment.

Strabismus in children can be constant or intermittent. Non-permanent divergence is found quite often, for example, in infants, and it does not cause much concern among specialists. Constant divergence is almost always the cause congenital anomalies development of visual analyzers and requires serious treatment.

Hidden

Hidden strabismus is quite difficult to recognize. With it, the child sees normally, with two eyes, which are positioned absolutely correctly and do not deviate anywhere. But as soon as one eye is “turned off” from the perception of visual images (for example, covered with a hand), it immediately begins to “float away” horizontally (to the right or left of the bridge of the nose) or vertically (up and down). To determine such a pathology, special ophthalmological techniques and devices are required.

Imaginary strabismus occurs due to completely normal features eye development in a particular child. If the optical axis and the visual line do not coincide, and this discrepancy is measured at a fairly large angle, then a slight false strabismus may occur. With it, vision is not impaired, both eyes see, the image is not distorted.

Imaginary strabismus does not require correction or treatment at all. False strabismus includes cases when a child begins to squint a little due to some structural features of not only the eyes, but also the face - for example, due to the size of the orbits, the shape of the eyes or the wide bridge of the nose .

Such a vision defect can be corrected in almost all cases; the main thing is that parents contact an ophthalmologist in a timely manner, without delaying the visit to the doctor. If after six months or a year the baby’s strabismus does not go away, treatment should be started.

There is no need to be afraid of therapy; in most cases it is possible to do without surgery. Surgical intervention is prescribed only when all other methods are unsuccessful.

Modern medicine offers many ways to correct strabismus. This and hardware treatment, and physiotherapy, and special gymnastics to strengthen the oculorotatory muscles and optic nerve.

The treatment schedule is prescribed strictly individually, taking into account all the circumstances and reasons that led to the development of strabismus. ABOUT however, every treatment plan includes key points and the stages that will need to be completed in order for the correction of the visual defect to be most successful:

First stage. Includes treatment of amblyopia. The goal at this stage is to improve vision, increase its acuity, and bring the acuity values to normal. To do this, they usually use the method of wearing glasses with a sealed lens. In order not to frighten the child with such a medical device, you can use special children's adhesives (occlusions). At the same time, several courses of hardware treatment are prescribed.

The strabismus itself does not go away at this stage, but vision usually improves significantly.

Second stage. Includes procedures that are aimed at restoring synchrony and communication between the two eyes. For this they use special devices and devices, as well as corrective computer programs.
Third stage. It consists of restoring the normal muscular balance between the organs of vision. At this stage, surgical treatment may be prescribed if the muscle damage is sufficiently severe. However, in children's practice it is often possible to get by with techniques that parents can practice at home - gymnastics, eye exercises and procedures that physical therapy rooms in clinics can offer.
Fourth stage. At the final stage of treatment, doctors will try to do everything possible to fully restore the child’s stereoscopic vision. At this stage, as a rule, the eyes are already symmetrical, occupy the correct position, vision can be improved, and the child is able to see clearly without glasses.

Based on this sequence, the doctor will individually select a program for correction.

After 2-3 years of treatment according to the prescribed regimen, the doctor will be able to conclude whether the baby was cured - or whether surgery is indicated for him.

More details about some modern techniques Treatments for strabismus can be read below.

Hardware

Hardware treatment accompanies almost all stages of strabismus treatment, from the first, aimed at improving vision, and ending with the last, the development of stereoscopic vision. To correct the problem, there is a fairly large list of devices that a child can use in a clinic or at home - if parents have the opportunity to buy such equipment:

Amblyocor device. Used to improve vision. It is a monitor and a system of sensors that record nerve impulses during the operation of the visual organs. The child simply watches a movie or cartoon, and the sensors create a complete picture of what is happening inside his visual analyzers. Special video programs allow you to send the “correct” impulses to the brain and restore visual function at the finest (nervous) level.
"Synoptophore" apparatus. This is an ophthalmological device that allows a child to view parts of pictures (both two-dimensional and three-dimensional) and combine them. This is necessary for the development of binocular vision. Exercising on such a device trains the eye muscles well. For each eye, the child receives only parts of the image; attempts to combine them will be effective correction for strabismus at one of the final stages of treatment.

Amblyopanorama. This is a simulator with which you can begin to treat strabismus even in infants, because no effort is required on the part of the child. It is enough for him to look at the disk with blinding fields, wearing glasses with corrective lenses prescribed by the doctor, and try to examine the objects. From time to time, the so-called retinal flare will occur. The simulator is very useful at the initial stage of strabismus treatment.
Apparatus "Rucheek". This device can be very helpful at the stage of training the extraocular muscles and learning to control accommodation. The child will have to track approaching and receding figures with his eyes, and also make various eye movements, as light points will flash in a variety of directions in the field.

Hardware treatment can be carried out both in a clinic and at home.

Typically, a child at the initial stage is prescribed 3-4 courses, each of which includes at least 10 lessons. At subsequent stages of strabismus treatment, the duration and appropriateness of hardware treatment courses are determined exclusively by the doctor.

Due to the emergence of a large number of private clinics and ophthalmology offices that offer paid hardware treatment, but practically do not examine the child, many negative reviews have appeared about such treatment. Parents claim that the procedures and training did not help the child.

This is in once again proves that any therapy must be prescribed by the attending physician. If he sees that the degree and nature of the eye damage are such that hardware treatment is not enough, he will definitely choose other methods for the child.

Eye gymnastics and classes

In some cases, with minor strabismus of non-paralytic origin special exercises help at the stage of strengthening the oculomotor muscles. This is a treatment that does not require large expenses, but requires mandatory and strict adherence to the principle of systematic training.

Gymnastics with a child is best done in daytime, in daylight. It is better to perform exercises with glasses. Gymnastics should become daily; it is advisable to repeat a set of exercises with the child 2-4 times a day. The duration of each lesson is from 15 to 20 minutes.

It is impossible to explain the essence of gymnastics to the youngest patients, and therefore it is recommended to simply play with them - moving balls, bright cubes and other objects in front of them, blindfolding one eye or the other.

For older children, it is advisable to use an occlusion or an eye patch only if the strabismus is monocular in nature. Children over 3 years old are encouraged to look for differences in the pictures every day. Today on the Internet there are many such tasks that parents can use a color printer and offer to their child. To begin with, it is recommended to take simple pictures with a small number of differences, but gradually the difficulty of the puzzle should increase.

It is useful for kindergarten-age children with strabismus to decide every day maze puzzles. These are drawings. The child is asked to take a pencil and lead the bunny to the carrot, the dog to the booth, or the pirate to the ship. Such pictures can also be downloaded from the Internet.

Gymnastics for the eyes in the treatment of strabismus is very useful at the stage of formation of stereoscopic vision. To do this, you can use ready-made programs compiled by Professor Shvedov or Doctor of Psychology, non-traditional healer Norbekov. However, in no case should you choose a method yourself. Incorrectly chosen and used exercises can lead to vision loss.

Any gymnastics should be discussed with your doctor.

The ophthalmologist will show and teach you how to do many exercises that are suitable for a particular child.

Surgical method

The help of surgeons has to be resorted to when conservative treatment has not been successful, when there is a need to restore the normal position of the eye, at least cosmetically, and also at the treatment stage, when there is a need to strengthen the muscles responsible for eye movements.

There are not many options for intervention for strabismus: surgically they either strengthen the muscle that is weak and poorly holding the eyeball, or relax it if it stably fixes the eye in the wrong position.

Today, most of these operations are performed using laser systems. This is a bloodless and gentle method that allows you to leave the hospital ward the very next day and go home to a familiar and understandable environment for the child.

For young children, the operation is performed under general anesthesia.

For older boys and girls - under local anesthesia. Most effective surgery is considered at the age of 4-6 years; at this age, correction using surgical techniques provides the best results.

At rehabilitation period Children are prohibited from swimming (for a month). The ban on other sports also applies for almost the same period of time. After the operation, for several weeks you should not rub your eyes with your hands or wash your face with water, the quality and purity of which are highly questionable.

After such an operation, a child will be able to return to the children's group (to kindergarten or school) only 2-3 weeks after discharge. For half a month, you will have to carefully follow all the doctor’s orders and prescriptions, including daily eye drops with antibiotics or other anti-inflammatory eye medications.

Prevention

Preventive measures that will help protect a child from strabismus cannot be postponed until later. They should start on the same day the baby is brought home from the maternity hospital. You need to do the following:

You should make sure that the room where the baby will live is well lit and that there is enough artificial lighting in it for the evening.
Do not hang toys too close to the baby's face in a crib or stroller. The distance to the eyes should be at least 40-50 cm. Another big parental mistake that often leads to the development of strabismus is a single bright toy hung in the center in front of the child. It is best to hang two toys - on the right and on the left, so that the baby can switch his gaze from one to the other, thereby training the oculorotatory muscles.
Small toys are not suitable for babies not only because they can choke on them. He will definitely try to look at them, and to do this he will have to narrow his eyes tightly to the bridge of his nose, bend low over the toy, or bring it too close to his face. Such children's experiments are in no way useful for the eyes.
Learning, writing and reading too early (before 4 years of age) can also lead to the development of strabismus, since the unformed visual apparatus becomes very tired during activities that require maximum focus and concentration.
If a child is sick with the flu, scarlet fever or another infection, you should not keep him busy reading, drawing or cross-stitching. During such illnesses, the risk of complications from the most different organs and systems of the human body.

The child’s diet must contain foods and vitamins necessary for the formation normal vision. To do this, it is worth choosing products and vitamin complexes, which contains large number vitamins A, B1 and B2, as well as PP, C, and E.
You should be attentive to the fears and experiences of the little man, because psychological factor is far from the least among the causes of the development of pathology. It is very important that the baby grows up in a friendly atmosphere so that parents can protect him from all frightening factors. You should avoid making too sudden movements around a small child.
Children should strictly limit the amount of time they spend on the computer and watching television, and ensure that they do not use gadgets uncontrollably, especially while traveling on a bus or in a car.
If there is a genetic predisposition to strabismus, the child should be shown to the ophthalmologist more often, visiting the doctor's office not only during scheduled appointments (at 1, 6 and 12 months), but also in the intervals between these periods - to make sure that pathological process didn't start.

For more information about strabismus, see the next episode of Dr. Komarovsky’s program.

There are two established points of view in society about strabismus: the first implies that it cannot be treated at all, and the second - that it goes away on its own without the participation of a doctor. Both opinions are fundamentally wrong - the sooner parents turn to a specialist, the faster and more successfully the baby will be cured of this illness. Strabismus in a newborn child is not only a cosmetic defect. It affects mental and mental development.

When does strabismus go away in newborns? What should I do and which doctor should I contact if my child’s eyes start to squint? Is it possible to cure the disease completely?

Why do babies cross their eyes?

Strabismus, or strabismus, is a disorder of the eye muscles, in which the child is unable to focus on an object with both eyes. Normally, both eyes, left and right, move symmetrically. With strabismus, the central axis is shifted, the pupils look in different directions. At the same time, the brain is not able to combine images seen with different eyes into one.

Strabismus in newborns can develop in the womb or at birth and occurs for the following reasons:

consequences of difficult childbirth;
infectious diseases of the mother during pregnancy;
maternal use of certain medications or drugs;
genetic diseases, such as Down syndrome;
hereditary predisposition;
congenital defects of the eye structure;
birth of a child prematurely;
hydrocephalus.

There are a number of unfavorable factors due to which strabismus occurs in the first days of a baby’s life

During life, strabismus develops for the following reasons:

visual impairment, farsightedness and myopia - the child tries to focus his gaze on an object and strains his eyes very much;
diseases and abnormalities of the eye muscles;
inflammation of visual structures;
consequences of an infectious disease (measles, scarlet fever, influenza);
eye damage, traumatic brain injury;
stress and strong psycho-emotional states;
strong visual stress;
pathologies of the nervous system.

Types and symptoms of strabismus

According to the time of occurrence, strabismus is divided into congenital (occurs infrequently) and acquired (forms by 1-3 years of a child’s life). Strabismus also occurs:

permanent - this is the most common type, it is diagnosed in 75-80% of cases;
periodic - occurs in certain situations, for example, during illness or stress.

Periodic strabismus sometimes develops into a permanent form over time. If a child has one eye squint, this is monolateral strabismus; if both eyes squint, it is alternating.

The pupils can diverge in different directions:

converging to the nose - esotropia;
diverging to the temples – exotropia;
vertical deviation - up or down;
mixed type.

Symptoms inherent in strabismus:

the child tilts his head and squints when looking at or trying to focus on an object;
the baby does not perceive the depth of space and may bump into something when walking;
fuzzy, blurry image, doubling of objects;
pain in the head and eyes;
dizziness;
the child cannot look at the light.

With strabismus, the baby often squints and finds it difficult to look at bright light

Some of these signs are always present. Others appear during severe stressful situations, fatigue or illness.

Diagnosis of pathology

Already at the first visit, at 3 months, the doctor will be able to determine visual impairment using ophthalmoscopy and measure the angle of deviation of the image on the pupil.
Skiascopy will help determine how the eye refracts light rays and whether there are functional disorders. By 6 months, signs of strabismus should disappear.
The eye-covering test reveals hidden strabismus. It is carried out at the age of 1 year. One eye is closed, and the baby is asked to follow the object with the other. Deviation to the side indicates the presence of strabismus.
At 3 years of age, a special color test is used for diagnosis. It will help determine whether there are disturbances in binocular vision.
Examination with a special apparatus - a synoptophore. By influencing the baby's eyes, the angle of deviation of the pupil from the healthy position is measured.

An ophthalmologist diagnoses strabismus during a visual examination of a baby. Correction of strabismus

Treatment depends on the cause of strabismus and the degree of damage to the visual organ. If necessary, a pediatric neurologist will be involved in therapy. If the pathology is serious, it will be treated in a hospital. In other cases, outpatient and home treatment is provided.

Treatment of strabismus must begin immediately, since vision is significantly affected as the disease progresses. Only the doctor decides which therapy is suitable for a particular child.

Treatment methods used to correct strabismus:

An occluder is a special shutter that is placed on the healthy eye (for unilateral strabismus) or on both in turn (for bilateral strabismus). As the load increases, the diseased organ begins to see better.
Wearing special glasses - when the cause is visual impairment (farsightedness, myopia or astigmatism), wearing glasses completely eliminates this defect.
Special eye drops. They temporarily impair the visual function of the healthy eye, forcing the affected eye to work harder.
Amblyocor is a device that helps brain neurons correctly interpret the picture and eliminates the “lazy eye” syndrome.
Synoptophore - trains the eyes and restores binocular vision.

Synoptophore eye exercises are effective for strabismus.

Amblyopanorama is a device that improves visual acuity.
Exercises for the eyes. They eliminate strabismus at the initial stage with minor damage to the visual organ and strengthen the muscles of the eye.
Surgical intervention. It is performed for children over 3 years of age and is indicated in cases where the conservative treatment described above does not bring results. For children, safe mild anesthesia is used. The surgeon will adjust the eye muscles so that they work normally.

When does strabismus go away in infants?

The visual system of a baby after birth and up to 3-4 years is unstable, since it is at the stage of formation. Her pathologies can be triggered by seemingly ordinary things, for example, watching TV, playing on a mobile phone, or a toy hanging too low in the cradle. That is why at this age special attention should be paid to the prevention of strabismus.

All babies under 2-3 months cannot yet focus their gaze on an object, so a slight deviation at this age is not scary and is a variant of the norm. By 3-6 months this phenomenon disappears.

However, you shouldn’t wait until a newborn’s strabismus goes away - it’s better to play it safe and consult a specialist for advice.

True strabismus develops at 2-3 years, when the joint functioning of the eyes is established. It can be diagnosed by the child's incorrect head tilt and wandering gaze. However, in some cases, strabismus converging to the bridge of the nose can go away on its own, even if it appears in children over 2 years of age.

Prevention

To prevent strabismus in a newborn and older child, you need to:

during pregnancy, regularly visit an antenatal clinic and undergo all necessary tests;
mothers should not take medications not intended for pregnant women, much less drink alcohol or use drugs;
for correct and timely diagnosis, you need to regularly take your baby to a pediatric ophthalmologist;
You cannot hang bright toys above the crib - the baby will concentrate his gaze on one point;
rattles should be placed at arm's length for the child;
You should start watching television programs no earlier than 3 years old, and play and study on the computer no earlier than 8 years old;
you should pay attention to the child’s posture, teach him to sit correctly, with a straight back;
It is necessary to create a favorable psychological climate in the family - to avoid quarrels and conflicts, and not to expose the child to stress.

Highlight the following types strabismus in children: strabismus in newborns, imaginary, hidden and true strabismus.

Strabismus in newborns

It occurs due to low visual acuity and the baby’s lack of ability to fix an object with both eyes (binocular vision).

Remember that a newborn's eye begins to function only after birth. The small size of the structures and the physiological characteristics of the formation and analysis of images cause strabismus in infants.

By 2 - 3 months, the baby is able to recognize close people who spend a sufficient amount of time with him. It is likely that the recognition process in this case is due to the first attempt to combine information from all senses, since visual acuity is still low.

By 4 - 5 months, when the child begins to actively and for a long time follow the object of interest to him, strabismus in infants gradually decreases and disappears.

Unlike newborns, in children older than 6 months, the first attempts to fix an object with both eyes begin to appear, and, consequently, the ability to three-dimensional vision. The brain merges the images received from the eyes into one picture, which allows us to talk about binocular vision. It is believed that when strabismus completely disappears in newborns, the eye begins to function fully.

If after 6 months strabismus does not go away, but on the contrary, begins to increase, then you should consult an ophthalmologist.

To correct strabismus in children 4-5 months old, it is recommended to use mobiles, bright large toys, following the movements of which the child begins to try to fixate on the object for as long as possible.

Imaginary strabismus

Imaginary strabismus is a variant of the norm. Associated with asymmetrically located eye sockets, features of the facial skull, the presence of a one-sided fold of skin in the corner of the eyes (epicanthus), as well as individual characteristics the relationship between the optical and visual axis of the eye. Visual functions not violated. In this case, strabismus in children is not treated.

Hidden strabismus

Orthophoria, or the ideal balance of both eyes, ensured by the eye muscles, occurs in only 20% of cases, the remaining 80% are characterized by heterophoria. This occurs due to individual anatomical structure eye muscles, position of the eyeballs, innervation features.

It should be noted that visual analyzer creates one overall image by merging the images received from the two eyes separately. Therefore, the balance of the extraocular muscles is usually not disturbed, and strabismus may not be detected.

Prolonged work near the eye requires high tension in the eye muscles, which leads to deterioration of health and the appearance of migraine-like pain. Typically, the appearance of such conditions occurs in children 6 to 7 years old who have started school.

Since it is sometimes quite difficult to determine whether a child has strabismus or heterophoria, they must use methods that allow them to study binocular vision. With strabismus such vision is absent, but with heterophoria it is preserved.

If the measures were unsuccessful, and the condition progressively worsens, surgery is performed to correct strabismus in children.

True strabismus in children

True strabismus exists in two forms - concomitant and paralytic.

Concomitant strabismus

Studying genetic predisposition to the disease of concomitant heterotropia showed that it is not strabismus itself that is inherited, but the structural features of the eye structures that lead to strabismus.

With this type of strabismus, divergent and converging concomitant strabismus are distinguished. The difference between the two forms lies in the location of the so-called visual axis of one eye in relation to the point of fixation. Thus, divergent strabismus in children manifests itself when the visual axis of the squinting eye shifts from the point of fixation to the temple.

Then a visible divergence of the eyes occurs. Convergent strabismus in children occurs when the visual axis of the converging eye moves away from the point of fixation towards the nose. The visible difference in forms makes it possible to establish the causes of strabismus in children, as well as the characteristics clinical manifestations, which the attending physician must take into account.

Remember that external and internal environmental factors in conditions of unstable binocular vision can provoke concomitant strabismus in children under one year of age.

Reasons

The main reason for the development of such a pathology is considered to be a pronounced difference in visual acuity between the organs of vision, as a result of which the brain begins to move the eye with low vision to the side. A child may also develop strabismus when the images obtained on the retina of the eyes are of different sizes.

In the case of certain refractive errors that were not treated and corrected by prescription of glasses or lenses, heterotropia can also develop. Thus, in case of myopia the disorder is represented by divergent strabismus, and in case of farsightedness it is represented by convergent strabismus.

Treatment

All strabismus treatment methods applied to a child are aimed at achieving binocular vision.

It should be understood that you should begin to treat strabismus by identifying the problem that led to it.

The ability to merge images obtained from both eyes, achieving high visual acuity (both with and without correction), the absence of amblyopia, the presence of sufficient mobility of the eyeballs, the symmetrical position of the eyes in the sockets - these are the criteria by which the effectiveness of treatment is judged.

Treatment of strabismus at home is aimed at combating amblyopia by eliminating the eye that sees better from the act of vision, as well as conducting a special program of orthoptic exercises.

The synoptophore apparatus, used for both treatment and examination of patients, allows one to establish the ability to merge images. WITH diagnostic purpose you can even determine the width of the merger reserves. The synoptophore makes it possible to establish both subjective and objective features of the visual analyzer.

Orthoptic exercises are indicated if amblyopia is absent, or the visual acuity of the worse-seeing eye begins to steadily increase through pleoptic exercises. Synoptophore allows you to carry out exercises aimed at improving eye mobility, which is especially important for eliminating problems with visual fixation.

A special muscle trainer can also be used to train children in a playful way. The synoptophore apparatus can be used in children over 4 years of age who have a pronounced lack of binocular vision. Diploptic exercises are used in children aged 2-3 years.

Surgical treatment of strabismus is indicated for children over 3 years of age if the treatment is insufficiently effective. conservative therapy. Operations on oculomotor muscles are aimed at achieving symmetry in the position of the eyes, which should become an incentive to establish binocular vision.

If after strabismus surgery the deviation of the eye remains, then it is recommended to carry out the next stage surgical treatment in 6 months.

Paralytic strabismus in children

Cause of the disease

Damage to the oculomotor, trochlear and abducens nerves, which innervate the extraocular muscles.

If one muscle is affected, the eye usually turns in the opposite direction. Fixing an object with both eyes is difficult. Paralysis completely blocks the response of the muscle, so there is no eye movement in its direction or it is very limited.

There is double vision and dizziness, which goes away if one eye is closed. A forced positioning of the head may occur, which may slightly reduce symptoms.

An ophthalmologist, taking into account the peculiarities of fixation of objects, can determine the affected muscle or group and determine which nerve was hit.

Treatment

Remember that before treating strabismus, you should establish what causes the main process, determine its course and dynamics.

Treatment involves electrical stimulation of the affected muscle and exercises. Double vision is eliminated with prismatic glasses, and occluders are used in those parts of the visual field where double vision is observed.

Correction of strabismus in children by surgery is possible only 6 - 7 months after the main process has stabilized. In case of congenital paralytic strabismus The intervention is recommended for children over 3 years old.

But he carefully studies everything within these limits - the angle of the crib, the play of light and shadow on the wall, the shape of the mobile. However, most of all the baby prefers to look at human faces. In your arms, his attention is automatically drawn to your face, especially your eyes. Often, just the sight of your eyes makes him smile. Gradually, his field of vision will expand and he will be able to look at your entire face, and not just its individual features, such as the eyes. When this happens, the baby will become much more responsive to facial expressions involving the mouth, chin and cheeks. He will also enjoy looking at himself in the mirror. Buy an unbreakable mirror specifically designed to fit inside cribs and playpens so your baby can have fun when you're not around.

Soon he will be able to follow with his eyes an object moving in a full semicircle in front of him.

In the first weeks, the baby is unable to follow moving objects with his eyes. If you quickly wave a ball or toy in front of his face, he will simply look through it, but if you shake your head, he will let your eyes out of his sight. But by the age of two months, his eyes will be able to move and focus in sync. Soon he will follow with his eyes an object moving in a full semicircle in front of him. Increased eye coordination will also allow the child to keep objects moving towards and away from him in focus. By three months of age, the baby will have enough control over his arm movements to hit objects moving above or in front of him. He will still miss for quite some time, but practice will help him develop hand-eye coordination. However, if by age three months your baby is unable to follow a moving object with both eyes at the same time, contact your pediatrician.
At the same time, your ability to see at a distance will also improve. You may notice your baby smiling at you from the middle of the room at three months or looking at a toy a few feet away. By four months, you will begin to catch him looking out of the window or watching the screen of a TV set quite far away. All this points to normal development ability to see at a distance.
At approximately the same rate, a baby develops color vision. IN one month old He is quite sensitive to the brightness or intensity of color, so he prefers to look at clear black and white or painted patterns in contrasting colors. Due to limited color vision Young children do not appreciate the soothing pastel shades that are usually used to decorate a nursery. Around the age of four months, the child will finally begin to distinguish the entire spectrum of colors and their many shades.

By the age of two months, the coordination of the baby's eyes improves - they move and focus synchronously.

As vision develops, the child will, of course, want to look at something more interesting. At about one month of age, his favorite designs are simple linear images such as wide stripes or large checkered patterns. By three months, he is much more interested in circular patterns (concentric circles, spirals). This is one of the reasons why babies are so attracted to faces that are full of round shapes and curves.

Stages of vision development by the end of the period under review