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Vision of newborns: norm and pathology
The vision of a newborn is rapidly developing in the first months of life. Parents should be aware of the features and problems of the organ of vision in the newly born baby. And also how to warn or react to various anomalies. And what, in fact, is a pathology, and what concerns the variant of the norm.
- Глаза и зрительная функция новорождённого 1 Eyes and visual function of the newborn
- Постепенное развитие младенческого зрения 1.1 Gradual development of infant vision
- Как видит ребёнок в первый год своей жизни: видео 1.1.1 How a child sees in the first year of his life: video
- Постепенное развитие младенческого зрения 1.1 Gradual development of infant vision
- Уход за глазами новорождённого 2 Newborn Eye Care
- Возможные проблемы с глазами при различных заболеваниях, их решения 3 Possible eye problems in various diseases, their solutions
- Опущение (птоз) верхнего века 3.1 Omission (ptosis) of the upper eyelid
- Ячмень 3.2 Barley
- Милиумы (просянка) 3.3 Milia (prosyanka)
- Дакриоцистит 3.4 Dacryocystitis
- Массаж при дакриоцистите: видео 3.4.1 Massage with dacryocystitis: video
- Инфекция 3.5 Infection
- Аллергический конъюнктивит 3.6 Allergic Conjunctivitis
- Чешуйчатый (себорейный) блефарит 3.7 Scaly (seborrheic) blepharitis
- Кровоизлияние в глаз 3.8 Eye hemorrhage
- Врождённая катаракта 3.9 Congenital Cataract
- Другие врождённые патологии и операция на глазах у новорождённого 3.10 Other congenital abnormalities and eye surgery in the newborn
The eyes and visual function of the newborn
Infants learn to see for a certain period of time, just as they learn to walk and talk. They are not born with all the visual abilities that they need in life. The ability to focus the eyes, smoothly translate them and use together, in a coordinated manner requires certain skills from the baby. In addition, children will have to learn how to apply the visual information that their eyes send to the brain in order to understand the world around and interact with it accordingly.
Close people play an important role in the development of the eyes and vision of the child. Mandatory actions of any parent should include the following steps:
- monitoring the condition of the eyes and eyesight;
- appeal to professionals if necessary;
- implementation of recommendations of pediatricians.
Gradual development of infant vision
In the moment when a child is born, he already has a visual function. However, it is only at the beginning of its development. At birth, babies cannot clearly see other people. Their eyes and visual system are underdeveloped. But significant changes occur already in the first few months of life. The eyes of a newborn have a visual acuity of 0.05, which is rapidly changing and reaches an adult level of 1.0 to 3-5 years. Such rapid progress requires close attention of parents and pediatricians in the first year of a baby’s life.
The shape of the eyeball of a person is close to spherical. And the average size, according to echobiometry, is 16.2 mm in newborns. By the first year of a child’s life, this size increases to 19.2 mm, by 3 years - up to 20.5, by 7 - up to 21.1, by 11 - up to 22, by 15 - up to 23 and by 20–25 years about 24 mm.
After birth, the organs of vision of babies respond to all types of visual stimulation. Children can stare at a contrasting target, but have not yet developed the ability to clearly highlight an object or transfer eyes between two images. The focus is on objects 20–25 centimeters from their own face.
During the first weeks of life, the baby’s eyes are poorly coordinated, and it may seem that they wander or intersect. This is usually normal. However, if it seems that the eyes converge and diverge constantly, this is the basis for verification.
Normally, in the first months of life, the eyes begin to work together, and the vision improves rapidly. Coordination of the eye muscles is normalized as the child gradually learns to track moving objects and reach for them. By eight weeks, children begin to more easily focus on the faces of their parents or other people nearby.
Advice for mothers: parents love to decorate the nursery in beautiful pastel colors. In fact, such colors do not naturally stimulate the vision of a newborn child. Black and white, along with primary colors such as red, orange, yellow and blue, are a much more suitable alternative. This rule is also suitable for children's toys.
Weekly stages of the first days of a newborn’s life look like this:
- week 1: blurring - in the first week after birth, the child can more or less see only objects at a distance of 20–30 cm from his face;
- week 2: black and white - immediately after birth, the child sees the world in black and white, with shades of gray. After 3-4 months, he will gradually develop his color vision. Because of this, the baby loves so much (and it is useful for him) to look at contrasting colors in expressive geometric patterns;
- week 3: close attention - at this time the newborn can recognize the face next, but he still sees only at a distance of 20–30 cm. However, his attention now lasts longer. Instead of a few seconds, as before, the look of the crumbs can be delayed by 10 seconds;
- week 4: back and forth - the child begins to follow the thing when she moves forward, backward and in different directions. But he does this by turning his head.
At first, the parents of the newborn may face a number of alarming, but in fact, non-dangerous temporary symptoms. Here is what you need to know:
- yellowed whites of the eyes. The baby in the first days after birth may manifest jaundice of newborns, in particular, the whites of the eyes turn yellow. The phenomenon occurs both immediately after birth, and on 3-5 days. This is a physiological and safe symptom, the cause of which is the restructuring of the infant organism from the intrauterine to the independent life. It is explained by the breakdown of obsolete red blood cells and passes on its own within about one to two weeks;
- asymmetry of the palpebral fissures (not to be confused with the omission of the eyelid). Some parents may notice that one eye of a child is slightly larger than the other. Differences in shape, as a rule, are not dangerous and with time (by year and older) they become even. Occasionally, however, this may indicate a perinatal lesion of the child’s nervous system. It would be useful to show the kid to the ophthalmologist to make sure that there are no deviations;
- undefined eye color. Most babies come into the world with eyes from light blue to blue, which is explained by the absence of coloring pigment at this age. Gradually, the child acquires a permanent eye color, which depends on the amount of melanin - the pigment that is produced in the body and gives a certain color to the iris;
- "Bulging" eyes. The symptom of Graefe, which is present in some children and is manifested in the fact that the baby seems to be “goggling” or bulging eyes, as a rule, passes up to six months without a trace. Such a visual effect is not dangerous and occurs with a certain light or movement of the child, when a strip of sclera (albuminous membrane of the eye) can be seen between the iris and upper eyelid. Such a symptom may be a sign of insufficient maturity of the nervous system, then it also does not require treatment. The child just outgrows it. In the case of the presence of additional symptoms, such as tremor, excessive excitability, drooping of the head, squint, it is worthwhile in the near future to consult with a neurologist;
- sleep with parted eyes. This is not a pathology. This feature is typical for babies and is explained by the fact that they spend a lot of time in the phase of active sleep, when the orbits move and roll up, and the eyelids slightly open. Disappears on average at the age of 11–12 months.
Throughout the visual development of the infant, and especially in the first weeks, the best visual stimulation is the look of the guardian's face. There is scientific evidence that babies have a genetic preference for looking at human faces. However, kids are really attracted by hair. Babies love the contrast between our skin and hair color.
A pediatrician checks the condition of the eyes and eyesight of the newborn during scheduled visits. If there are no problems, then visits to an ophthalmologist with a baby under 6 months are optional. But in the case of suspicion of parents or pediatrician for any violations by the eyes of the newborn, you must immediately go to a specialist in pediatric ophthalmology.
How does a child see in the first year of his life: video
Newborn Eye Care
The eyes of a healthy baby do not require any special care. But, of course, the purification procedure is obligatory once a day. To do this, moisten a cotton pad in warm water and wash the corners of the child's eyes, wiping carefully from the inside corner to the outside. For each eye you need to take a new disk. After the procedure, you should gently soak the eyes of the child with a dry clean cotton swab.
Do not use tea leaves, decoctions of herbs or cosmetics for hygiene of the newborn's eyes. Enough ordinary boiled water. Be sure to pre-cool it to a comfortable temperature.
If a baby's speck, cilia or hair gets into the baby’s eye, it is recommended to clean it with a pipette, eye drops or saline. It is undesirable to do it with your hands or a napkin - you can damage the delicate mucous of the crumbs. In order to properly drop the eyes of a child, you need:
- Heat the drops (fit Vitabact, Floksal) or saline in the hands to a comfortable temperature.
- Lay the child on its side, opposite the eye, which must be instilled.
- To collect warm solution in a pipette.
- Holding the head of the child with one hand, the second gently drop 1-2 drops from the outer side of the eye so that the solution spreads to the inner corner (washing the cornea of the eye as a whole).
When the baby's eyes are clean and healthy, then massage or special treatment with additional means are not needed. On the contrary, it is better to interfere less with the work of the visual organ. Daily hygiene is enough.
Possible eye problems in various diseases, their solutions
Ophthalmologic problems in newborns are congenital or acquired due to irritation, infection, and other factors. Sometimes there is nothing to worry about, and the symptoms are not dangerous, but it happens that an infant's eyes require emergency medical care.
Omission (ptosis) of the upper eyelid
- different size of open eyes (omission of one century);
- inability to close the eyelid tightly;
- strabismus (not always);
- amblyopia - a lazy eye disease (optional).
Ptosis, or the descent of the upper eyelid, is a condition that occurs when one or both of the eyelids do not develop normally due to weakness of the eye muscles, impaired transmission of nerve impulses or lesions. A poorly functioning eyelid is lowered or slightly open. The cause of pathology can be a congenital defect, a tumor of a nerve or blood vessels of the upper eyelid, trauma during childbirth, as well as other causes of a neurogenic nature. If the defect is not corrected, it can lead to a later development of the "lazy eye" - a reversible loss of function of one eye, which sometimes leads to persistent loss of vision.
Treatment: with mild - regular observation. If ptosis interferes with the normal development of visual function, then surgical intervention is indicated.
The eyes of a newborn with Down syndrome have a characteristic external feature - the epicantus, or “Mongoloid fold” - this is a vertical fold at the inner corner of the eye, covering the tearful tubercle. Together with other specific signs, this symptom indicates the presence of chromosomal pathology.
- abscess on the eyelid as a dense pimple;
- swelling and redness at the edge of the eyelid;
Barley on the eye is an acute purulent inflammation in the sebaceous or meibomian glands of the hair bulb on the edge of the eyelid or on the back of the eyelid. It has an infectious nature, its pathogen most often - Staphylococcus aureus. The bacterium, which under normal conditions in a certain amount is on the skin of almost any person, under the influence of a number of adverse factors - hypothermia, reduced immunity, other infections of the skin or eyes - provokes inflammation.
Treatment: use antibacterial eye drops (Levomitsetin, Floksal), eye ointments (Floksal, Erythromycin). The drugs are used only after a medical examination and doctor's prescription.
- small white spots on the upper or lower eyelid;
- similar pimples in the mouth on the mucous membrane (in 85% of cases).
Prosyanka is the result of blockage of sebaceous glands due to insufficient exfoliation of dead skin cells. Milia can occur due to improper hygiene, as a reaction to certain allergens or ultraviolet light. Pimples do not cause negative feelings: do not hurt, do not itch. Not dangerous.
Treatment does not require, and pass independently within several weeks.
- lacrimation and lacrimation;
- swelling in the lower eyelid area;
- redness in the inner corner of the eye;
- purulent discharge from the eye, including with pressure on the region of the lacrimal sac.
Dacryocystitis, or partial blockage of the lacrimal canal in children, occurs as a result of a violation of the natural path of the tear, which is normally produced by the gland incessantly and is designed to cleanse the eyes, protect against pathogenic microorganisms, etc. updated, evenly spreading over the entire surface of the cornea. The lacrimal tubule of the lower eyelid ensures an unobstructed outflow of 9/10 parts of all produced tears. The lumen of the canal can be narrowed due to physical causes, for example, remnants of embryonic tissues that block the path of fluid — the so-called gelatinous plug. The process is one-way and two-way. More often one eye is affected.
Treatment: consists of massage and the use of medicines. The parent or guardian conducts massaging of the lacrimal sac at the inner edge of the eye after demonstrating the correct technique by an ophthalmologist. It is necessary to press on the lacrimal sac with little effort up and down. If, as a result, pus leaves the place of accumulation, then the massage is performed correctly.
The second part of the treatment is flushing the palpebral furacilin solution. It is necessary to wet a cotton disc in it and hold it several times over the eye from the temple to the nose. Then Levomycetinum 0.25% is dropped to the affected eye. The treatment has a favorable outcome and lasts no more than 2 weeks. In particularly severe and advanced cases, it may be necessary to wash the tear ducts using an ophthalmic probe and an antiseptic on an outpatient basis.
Massage with dacryocystitis: video
- eyelid edema and redness (above or below the eyes);
- peeling around the eyes, itching;
- severe tearing;
- mucopurulent discharge;
- eye redness and pain;
- temperature rise;
- inflammation of the upper respiratory tract (optional symptom).
Infection is often caused by pathogens such as gonorrhea (Neisseria gonorrhea) and chlamydia (Chlamydia trachomatis), as well as genital and oral herpes viruses, fungi. It is sometimes transmitted to the child during childbirth, penetrating from the genital tract of the mother. Pathogenic microorganisms, often asymptomatic in the maternal organism, infecting the infant, provoke inflammation of the conjunctiva. Complication is severe edema, purulent-bloody discharge, damage to the deeper medium of the eye - a rather dangerous condition, called gonoblenie (acute conjunctivitis), it can end with serious consequences up to atrophy of the eyeball. Viral infection is transmitted by airborne droplets, and conjunctivitis of viral origin occurs as a complication after chickenpox, measles, etc. A characteristic feature of fungal conjunctivitis is peeling of the skin on the eyelids and itching.
Treatment: bacteriological analysis is shown to identify the pathogen. If a bacterial infection is confirmed, antibiotic treatment is carried out, often in the form of drops and ointments locally. Dangerous gonococcal and chlamydial infections, especially with the involvement of the cornea in the inflammatory process, require the systemic administration of antibacterial drugs. Special antiviral eye drops or ointments are used to treat herpes. Anti-fungal ointments are applied in the case of the causative agent of fungal origin. The outcome of timely treatment is usually favorable.
- redness of the eye and edema of the eyelid;
- itching (baby rubs eyes);
- lacrimation and clear secret;
- blurred look;
- restless behavior, crying.
Allergy in the eyes of a newborn can occur after contact with various provocateurs, ranging from house dust, animal hair, plant pollen, and ending with medicines and cosmetics (baby creams, oils), household chemicals, etc. In this case, the child’s immune system is rapidly reacts to a foreign substance, and an allergic reaction in the form of conjunctivitis occurs as a response. For the diagnosis requires a blood test for eosinophils - a type of white blood cells, responsible for the destruction of foreign protein in the body.
Treatment: the first thing to exclude any contact of the child with the identified allergen. To eliminate the symptoms and prevent further reaction, the doctor may prescribe antihistamines or corticosteroids for topical use (only after taking an ophthalmologist).
Scaly (seborrheic) blepharitis
- grayish scales at the roots of the eyelashes;
- thickening, swelling and redness of the edges of the eyelids;
- increased sensitivity and eyestrain;
- bonding eyelashes.
Blepharitis is an inflammatory process on the edges of the eyelids, most often caused by the bacterium Staphylococcus aureus. It has several species, but the most common flake is a type of seborrheic dermatitis. A characteristic feature is small, tightly-fitting scales at the edges of the eyelids, with which eyelashes at the roots are dotted. If the "dandruff" is carefully removed with a cotton swab, then ulcers and erosion will remain in its place, which will later be covered with a yellow crust.
Treatment: the scales gently soften the emulsion Sintomitsina 1%, then treated with an antiseptic. Use glucocorticosteroid ointment (prescription by an ophthalmologist).
- red spot in the eye;
- bruising or red vessel on the white of the eye.
Literally from birth, relatives may notice a red speck or streak in the eye of an infant. In newborns, all vessels, including the eye, are still fragile and may burst during childbirth, from strong crying or tension, fatigue, lack of sleep. The kid often rubs his eyes because of irritation with dry air or bright light. Mechanical action can also cause damage to the vessel in the eye.
Angiopathy (phlebopathy) of the retina - varicose veins - is a controversial diagnosis in relation to newborns, although quite common in the CIS, but absent in Western countries, since it involves the destruction of vascular tissues, which in babies are not detected during the examination. The conclusion is based on the fullness of the blood of the veins and the narrowing of the arteries. When re-examination after a few minutes of expansion of blood vessels can no longer be detected. It disappears after a change in body position and may arise from physical or emotional efforts, being a temporary non-dangerous symptom.
Treatment: special therapy is not required. Within a few days the spot will resolve itself, for this it is necessary to ensure peace and adherence to the day regimen, according to the age of the baby. Eliminate all possible irritants. Vasoconstrictor eye drops are not shown to newborns, they are allowed to apply to children older than two years. If the vascular in the eye bursts regularly and too often, or the symptom does not go away more than 7–10 days, it is necessary to show such a child to a pediatrician or an ophthalmologist.
- dull eyes in the region of the pupil (clouding in the form of a disk, a dot or in some places);
- frequent oscillatory eye movements (running eyes) - nystagmus.
Blurred eyes in a newborn may indicate the presence of an infant cataract, in other words, clouding of the lens of the eye. Normally, light travels through the cornea and the pupil to the lens (lens). It acts like a camera lens and focuses the light before passing it to the retina. When the lens is clouded, it obstructs the passage of light and results in impaired vision.
The film in the corner of the baby's eye, which is on the protein, when the organ of vision rotates, can be a fold of conjunctival mucosa, which gradually smoothes with the growth of the child's eyes. However, it is recommended to look like an oculist, as a congenital cystic tumor - conjunctival lipodermoid - has a very similar appearance. Education is removed surgically under general anesthesia, if it increases or creates visual disturbances; if the function of the eye does not interfere, simply observe.
Treatment: important early diagnosis of the disease. If the clouding in the lens is small and does not hinder the visual development of the child, then an observation is shown. When a cataract impedes visual function, it must be surgically removed. Unfortunately, it is not treated with medication.
Other congenital abnormalities and eye surgery in the newborn
There is such a defect as an eyesore in the newborn - a white or yellowish dull spot on the cornea - a scar from the connective tissue, resulting from its injury or inflammation (keratitis). More often is congenital. It happens in the form of a cloud or a spot, it can be located in different parts of the eye. If the thorn does not interfere with vision, then it is observed, and keratitis is treated conservatively, selecting a drug that acts against the pathogen. Directly on the thorn, they are influenced by the resorption of scars in drops, as well as by means for the regeneration of corneal defects. Surgical solution is most effective, but it is prescribed on the basis of expediency.
Bruises, or circles under the eyes of a child, are often hereditary. The effect occurs when the vessels lie close to the thin surface of the skin. The fatty layer in the lower eyelids is absent, so the small vessels are translucent, visually dyeing the skin in a bluish color.
Dermoid cyst of the sclera or cornea is a congenital defect of benign character, having a fetal origin. The cyst contains remnants of the ectoderm and mesoderm (layers of germinal layers), covered with connective tissue. Outwardly, it looks like a small growth or a cloudy spot in the area of the white of the eye, sometimes “floating” on the iris. Dermoid in the optical zone of the eye dramatically reduces visual acuity and requires removal. The treatment in this case is surgical, and its appropriateness is determined by the ophthalmologist on the basis of the size of the cyst, the growth rate and the readiness of the child’s body for anesthesia.
Other diagnoses that require urgent surgical intervention:
- retinopathy of prematurity - damage to the retina of highly pretermly born children;
- glaucoma (increased intraocular pressure);
- strabismus, etc.
Pediatric eye microsurgery, as a rule, as minimally invasive as possible using specialized ophthalmic equipment. The ophthalmologist directs the operation when conservative treatment is impossible or ineffective, and the disease impedes the normal development of visual function or is threatened with blindness. Diagnostics and surgical intervention is performed under masked sevaranovogo anesthesia (inhalation type).
From birth, babies begin to explore the wonders of the world with the help of organs of vision. Even before they learn to crawl, walk, and take something with their hands, their eyes provide information and stimulation that are important for development. Healthy eyes and good vision play a leading role in learning. Problems in this area in babies can cause a delay in overall development. It is necessary to identify and treat possible pathologies in advance so that the child can fully develop the visual abilities he needs for growth and learning.