Eye problems that can affect babies and toddlers

• Some changes such as watery eyes are common in babies and often resolve themselves as the eyes develop.
• Persistent eye turn, redness, discharge, or swelling should be checked by an eye care professional.
• Early eye screenings and assessments help ensure healthy visual development and support clear, comfortable vision as your baby grows.

Babies are born with an immature visual system, so their vision is naturally blurry at first. From birth, most babies can already focus on and slowly follow things that catch their attention, such as bright, simple objects.1 

As vision develops over the first few years of life, the eyes and brain learn to work together, much like learning to walk or talk. A baby’s vision improves quickly during the first six months of life, then continues to develop more gradually throughout infancy.

Infants pass through predictable vision milestones, such as recognizing faces, grasping toys, and developing hand-eye coordination.2 Each stage helps build the foundation for later visual abilities. 

Parents should be aware if their baby is not meeting these milestones or seems to have difficulty tracking moving objects or making eye contact, as this could indicate a vision problem or a delay in visual development. 

The American Academy of Ophthalmology recommends a baseline eye screening at 6 to 12 months of age (or as recommended), to identify and treat vision problems as early as possible.3

Strabismus, also known as an eye turn or squint, happens when the eyes are not pointing in the same direction. This occurs when the muscles that control eye movement aren’t working together properly.

Mild eye misalignments are common in newborns, so a baby’s eyes can sometimes appear crossed or in the first few weeks of life.4 As a baby’s vision develops, the eyes begin to move together more smoothly, with normal coordination typically established by around 3 months of age. As a result, eye turns usually become less noticeable by around 2 months of age and most will have typically resolved by 4 months.

Persistent misalignment can cause the brain to rely more on one eye and ignore the other. If an eye turn isn’t treated during early childhood – ideally before around 6 to 8 years of age, the affected eye may not develop normal vision, leading to a permanent reduction in sight.5 This is otherwise known as amblyopia (or ‘lazy eye’). Treatment may include glasses, patching, or surgery, depending on the cause and severity.

Nasolacrimal duct obstruction (blocked tear duct) is the most common cause of watery eyes in babies, affecting approximately 6-20% of infants.6

Blocked tear ducts can occur within the first few weeks or months of life as the eyes start producing more tears, often causing watery eyes and a small amount of discharge. The skin around the eyes and eyelids may become red or irritated from constant tearing and wiping, and there may be some crusting around the lashes. 

This is a common eye problem as the tear duct is not fully developed from birth. The tear drainage system forms before birth, beginning as small channels that connect the eye to the inside of the nose. If the tear duct has not fully opened, this prevents the tears from draining properly and causes the tears to pool up – much like a blocked sink. 

In most babies, the tear duct opens naturally during the first year of life as the drainage system matures, so most cases resolve on their own or with minimal treatment. Even among infants who still have symptoms at 6 to 10 months of age, around two-thirds will experience resolution within the following six months.6

Conjunctivitis, often called ‘pink eye’, is inflammation or infection of the thin membrane that covers the white part of the eye and the inside of the eyelids. It can occur around the time of birth or later in infancy, usually due to exposure to bacteria or viruses.

Bacterial infection of the conjunctiva can occur when a child touches their eyes with unclean hands, and makes up for more than 50% of conjunctivitis cases in children.7 Signs include red eyes, yellow or green discharge, swollen eyelids, and crusting around the lashes. The eyes may feel sore and sensitive to light. 

This form can be contagious and requires assessment and treatment by optometrist or eye doctor.

Caused by viruses such as those responsible for the common cold viral conjunctivitis leads to redness, watering, irritation, and sometimes blurred vision. It may also occur alongside or after fever, sore throat, or fatigue.

Most cases resolve on its own within 1-2 weeks. If symptoms are severe or cause significant discomfort, an optometrist can provide advice to relieve symptoms.

This type usually presents with red, watery, and itchy eyes, occasionally with white, stringy mucous at the inner corner of the eye. It is commonly triggered by allergens such as dust, pet dander, or pollen. Symptoms are often seasonal and may occur alongside hayfever-like reactions, including sneezing and a runny nose. 

Treatment typically involves anti-allergy or lubricating eye drops prescribed by an optometrist or doctor.