Parents Often Ask – My Young Baby Sometimes Gets Crossed Eyes. Should I Worry?
With some rare exceptions, misalignment of the eyes can be quite normal in the first few months of life. The reason for this relates to how a baby’s vision develops in the early months of life.
Young babies are born with very poor visual acuity, meaning they can only clearly see objects that are presented within inches of their faces. Anything more distant and objects become very blurry.
If an object is held closely enough to a baby that s/he can see it clearly enough to focus, the eyes will hold straight and steady in that position; this is called fixation. If the object is pulled further away from the eyes (rendering it blurry to the baby), the eyes lose the ability to focus and so can no longer fixate. As a result, the eyes may begin to wander and appear crossed, walleyed or uncoordinated. Bringing the object back into close enough range, the image becomes clear, the baby re-fixates and the eyes appear straight again.
Over months, a baby’s visual acuity gradually improves allowing him/her to more clearly see objects presented at further and further distances. By 2-4 months of age, a baby’s visual acuity is typically good enough that no matter how far objects are from the eyes, fixation and alignment are consistently maintained. In other words, there should be no more episodes of crossed/crooked eyes in a baby older than 4 months of age.
There are a number of medical conditions that can lead to eye misalignment persisting past 4 months of life. Some of these conditions are serious and, if left untreated, can lead to permanent visual impairment. If, by 4 months of age, your baby is still having episodes of misalignment of the eyes, it is important to have a discussion with your doctor about arranging for a referral to an ophthalmologist for further evaluation.