Contents Chapter Topic Page Neonatology Respiratory Cardiology

Visual Assessment
Warning signs for Poor Vision
Does not fix on face of mother while
feeding by 6 weeks.
If the child's eyes wander from one corner
of the eye to the other after 6 weeks.
If leukocoria (white eye reflex) is noted at
any age.
Child holds objects very close to eye.
Squint in one of his eyes after 6 months of age.
Strong objection to covering one eye (good eye), but not the other (bad eye).
Blind mannerisms, abnormal head postures.
Development of Vision
When assessing vision in a young baby it is important to know the normal visual
attainment that can be expected at each age.
At birth Turn head towards source of light, follow face of mother if very
close, optokinetic nystagmus.
At 4 weeks Should follow light, dangling object < 90 o , visual acuity 6/60 at this
stage.
8 weeks Fixation, convergence, focusing.
12 weeks Hand regard. Dangling object 180 o . Visual acuity 6/18 - 6/12.
16 weeks Reach for any object in its view.
20 weeks Smile at mirror image.
8 months See Smartie or raisins, look for fallen toy.
10 months 100s and 1000s.
> 18 months Picture charts.
21mths/2 yr. Sheriden letters.
41mths/2-5yrs Snellen chart
At risk
Prematurity.
Small for Gestation.
Family history of cataract, retinoblastoma,
squint.
NB. If vision improves when child reads through pinhole, refer to optician for
spectacles.
Corneal reflection test for squint
Refer funny looking eyes, abnormal eye movements/head posture.