Newborn vision: What your baby sees

In the first few weeks and months of life, this is what the world looks like to your newborn.

The moment you lay eyes on your baby, you might wonder, can he actually see me, too?

“Newborns can see, but everything is very blurry for them at first,” says Tanya Sitter, an optometrist in Olds, Alta. Your baby can make out light, movement and shapes, but can only focus on objects that are between eight to 12 inches away from him, which is about the distance to your face when he’s being held during feedings. That’s why faces quickly become an infant’s favourite thing to stare at. He’ll get to know every detail of his parents’ faces right away, a process that plays a key role in bonding during those early days and weeks.

Nicole Manek, a new mom in Toronto, noticed that her three-week-old son, Leon, has found something else he loves to stare at as well: the wallpaper in his nursery. She decorated it in a space theme, not knowing how much he’d enjoy the white stars on a black background. High contrast patterns, especially black and white, will be easiest for newborns to see, says Sitter. “They can distinguish some colours within the first few weeks, but we don’t know exactly how much they can make out.”

Specially designed high-contrast rattles and stuffies are likely to pique his interest, but these so-called “smart toys” aren’t necessarily going to speed up his ocular development. Same goes for mobiles, though one hung above his crib may prove a welcome distraction when he wakes in the middle of the night.

“The best thing you can do is just interact with your baby as much as possible,” says Sitter. That means smiling, making funny faces and giving him lots of different things to look at. Everything from toys to ordinary household objects will be new and interesting. And you never know what might catch his attention. “We have a chandelier in our guest room and Leon can just stare up at the lights for hours,” says Manek.

Although newborns can see basic shapes, their eye muscles are weak and uncoordinated, making it hard for them to focus on, or follow, moving objects. Until your baby gets the hang of how to make his eyes work in tandem, it’s normal to notice one eye wandering. You may also notice that your infant sometimes has crossed eyes, but isn’t anything to be concerned about.

“I’ve said to my husband, ‘Oh no, Leon is cross-eyed again, look at him,’” says Manek. Sitter explains that as Leon’s eye muscles get stronger, this will eventually stop, but if it continues after the first two months, parents should make an appointment with an optometrist.

The eye doctor will check for what’s called strabismus, or misaligned eyes, which, in newborns, is often caused by muscle issues. It could also be amblyopia (lazy eye), which occurs when the pathway between one eye and the brain isn’t receiving the proper signals and nerve stimulation. Both are usually correctible conditions, especially if caught early.

Your doctor will briefly examine your baby’s eyes at his routine wellness visits, regardless. He shouldn’t need a full exam with an optometrist until he’s between six to nine months, unless something doesn’t seem quite right. Make an appointment sooner if you notice that one of his pupils looks white (this could be a sign of congenital cataracts, which may require corrective surgery), or if one of his eyes is persistently red and running. Conjunctivitis, or pink eye, can be caused by an infection or a blocked tear duct and may need antibiotics to be cleared up.

Did you know?

Your baby’s depth perception and clarity — meaning sharpness and fine details — won’t reach a high level of acuity until he is about eight months old.

For more information or to book an appointment, please visit us online at www.visionsourcenw.com or call us at 604.553.3900.

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Regular eye exams can detect glaucoma, 'silent thief of sight,' experts say

TORONTO - It turns out those ubiquitous tinted glasses worn by Bono aren't just glam rock-star posturing, but a way of dealing with light sensitivity resulting from glaucoma — a condition the U2 frontman was diagnosed with 20 years ago.

So just what is glaucoma and who is at risk for this potentially vision-stealing eye disease?

Glaucoma usually — but not always — results from a buildup of pressure within the eye, which occurs when the aqueous fluid cannot drain properly. Left untreated, the condition can lead to damage of the optic nerve, which transmits visual information from the retina to the sight centres of the brain.

Destruction of the optic nerve can mean vision loss, which typically begins subtly, creeping in around the edges of one's sight, says Keith Gordon, vice-president of research at CNIB, formerly known as the Canadian National Institute for the Blind.

"The vision loss usually occurs in the periphery, so it doesn't affect your vision for some time, until it starts closing in on your central vision, because you sort of adjust to bits and pieces of vision loss coming in from the side," says Gordon. "And then all of a sudden, one day you don't notice a car coming in from the periphery and you have a car accident and you realize that's what's happened."

Many people with glaucoma have no idea they have the disease because it usually causes no symptoms, and the slow erosion of sight can go on for years without notice, he says.

"It's a silent thief of sight."

Sheldon Francis had no idea he had glaucoma until he consulted an optometrist about a problem with his peripheral vision. "I was looking in the mirror one day when I was 23 and I noticed that my vision in the right eye was a little hazy, a little blurry."

He was referred to an ophthalmologist, who performed surgery on the eye and prescribed pressure-reducing eye drops.

"I was fine and I could still see perfectly fine out of my left eye, I still had 20/20 vision," says Francis, who lives in Toronto. But the doctor told him the glaucoma would likely occur in his left eye as well.

"He said later on I was probably going to go blind. He said he had not seen glaucoma progress so quickly in somebody that age."

Over time, that prediction came true. Today, at age 38, Francis is blind in his left eye and has only 10 per cent vision in his right. Two more surgeries last year were unable to overcome the severe damage to his optic nerves.

What Francis didn't realize is that he likely was born with the condition, or at least with a strong genetic predisposition for developing it: his mother and father, both of African descent, developed glaucoma at different stages in life. His dad had it early and ended up losing sight in one eye, but can see "perfectly" with the other; his mom was diagnosed later in life and with treatment has been able to maintain her vision.

"Because both of my parents have it, I got sort of the double-whammy," says Francis. "I had this disease in me since I was a kid and my parents just didn't realize that they needed to bring me to the optometrist to check for glaucoma.

"I tried everything in the early stages to prevent me from losing my eyesight so quickly, but it's just genetics."

Ethnicity seems to play a role in prevalence: blacks have a higher risk of developing one kind of glaucoma than do whites, while those of Asian descent and the Inuit are more prone to a second type. Some medical conditions, including diabetes, also raise the risk of developing the condition.

But most cases of glaucoma are age-related, with those over 60 having an increasingly elevated risk of developing the sight-diminishing disease as they add on the decades.

It's also fairly common — an estimated 270,000 to 400,000 Canadians have the condition, the leading cause of vision loss among seniors after age-related macular degeneration.

Worldwide, glaucoma is the leading cause of irreversible blindness, says Dr. Catherine Birt, an ophthalmologist at Sunnybrook Health Sciences Centre in Toronto who specializes in the disease.

"Glaucoma is not a single disease," explains Birt. "There are all kinds of subtypes — primary, secondary, open-angle, angle-closure — and they all have slightly different presentations and risk factors and treatments."

For the most part, glaucoma can be divided into two main types: open-angle and angle-closure, also called closed-angle glaucoma. Both are related to an inability of the fluid inside the eye to properly drain, leading to a rise in intraocular pressure that over time can damage the optic nerve.

With open-angle glaucoma — a reference to the angle formed by the cornea and iris — drainage channels are partially blocked. "The aqueous fluid can get into the drain, but it doesn't flow through properly," says Birt, noting that the exact cause of open-angle glaucoma remains unknown.

Angle-closure glaucoma occurs when tissue, perhaps from the iris or from scarring, blocks the drainage angle so the fluid is trapped inside the eye, often causing intraocular pressure to spike abruptly.

"These are the people who come into the emergency department with sudden severe eye pain and loss of vision," she says.

Treatment depends on the type of glaucoma and its acuteness. Doctors often start by prescribing eye drops that help to alleviate pressure inside the eye.

Laser surgery is also used: with open-angle glaucoma, a special laser can "tickle" the angle drain to make it work better, says Birt. "It does work. It's not a cure and the effects can wear off, but it can offer significantly improved pressure control."

A different type of laser is used to treat closed-angle glaucoma. "Someone with an angle-closure attack can have laser and be essentially cured, not all, but most of the time if we get to it," she says. "If we get to it fast enough, we can resolve the entire situation with the laser and consider that the patient does not have glaucoma."

Surgery is considered when drops and laser either don't work or the patient can't tolerate them, she says.

While high-risk — there can be complications such as bleeding and infection — the delicate eye surgery can be highly beneficial, lowering the pressure inside the eye and stabilizing the condition for a significant length of time, says Birt, who performs six to eight glaucoma surgeries a week on average.

"With our current abilities, it's not curable, but it can very often be stabilized. So it's a bit like having high blood pressure or high blood sugar. We can treat it, we can maintain it, we can control the situation.

"But we can't make it go away."

That's why, stresses Gordon of the CNIB, early detection is critical.

Anyone over 60 should have their eyes checked by an optometrist or ophthalmologist once a year, and that examination should include tests for glaucoma. Younger people, especially those of African descent or with a family history of glaucoma, should also be tested at least annually, he says.

"The key reason you have an eye exam is that you can get treatment early, and the earlier you get treatment, the better the chance you have of controlling vision loss," says Gordon, who agrees that people often take their vision for granted.

"People confuse good vision with good vision health. Because you can see well doesn't mean that your eye may not be harbouring something, particularly when it comes to glaucoma — because you could be losing sight and not be aware of it."

For more information or to book an appointment, please visit www.visionsourcenw.com or call us at 604.553.3900.

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Special Contact Lens Promotion!

We are currently offering a great in store rebate on contact lenses! Please feel free to contact us at 604.553.3900 for more information on the promotion!

SPECIAL CONTACT LENS PROMO

INSTANT SAVINGS!

April 15^th – June 15^th, 2015

Purchase 4 BOXES and get $20 OFF

Purchase 8 BOXES and get $50 OFF

Eligible Products:

DACP (Sphere, Multi Focal and Toric) – 90 Packs

Dailies Total One – 90 Packs

Air Optix Aqua (Sphere, Multi Focal and Toric)

Air Optix Aqua Color

Air Optix Night and Day

Freshlook Products (NOTE: after the POP was sent to print, Alcon was able to make this product eligible, so the POP fine-print will indicate this incorrectly).

NON-Eligible Products:

All 30 pack purchases

Glasses for Children

There are a few possible indicators that your child needs glasses. This could begin with a note from the teacher discussing difficulties in school or you may notice your child squinting or having frequent headaches. However, more likely you will only learn your child needs glasses when you take them to a Doctor of Optometry for a routine eye exam when there have been no indicators at all.

When choosing their first pair of glasses, start by ensuring that your child likes the style and colour of the frames that are being selected. A child will be more inclined to wear their glasses every day when they are happy with their appearance.

For a child to keep their new glasses on, the frames do need to provide a comfortable fit. For this reason the frame sizing and selection needs careful attention by an experienced fitter. Children often have small, flat bridges of their nose and since much of the weight of the frame is carried at that point, certain types of frames, often with adjustable nose pads, will be recommended. Children’s skin can be sensitive and large areas of frame contact should be avoided particularly if they have metal sensitivities. Also, your child will need a frame of good quality and one that is backed by a manufacturer’s warrant because it is inevitable that the frame will become bent, crooked or break.

The first priority of lens selection is safety. Lens materials such as polycarbonate and Trivex carry significant impact resistant qualities in addition to providing UV protection. Your child’s prescription may necessitate lens features such as aspheric surfaces or high index materials to keep them thin and light. All lenses should be provided with a very good quality scratch resistant coating and in some cases anti-reflection coatings although the latter will require frequent cleaning to ensure the maximum benefit and are more of a necessity as the child gets older or the prescription increases.

The delivery of the new glasses is an exciting time for your child. Make sure that they are fitted well. The frame should be level and properly positioned. They should not slip out of position with head movements and there should not be noticeable red marks on the nose or behind the ears after a few hours of wear. Your child will be excited to receive them so use this time to impress upon them the doctor’s wearing instructions. Also, build good care habits such as showing them how to use both hands to remove them and how to set them down properly, lens-side up. Many coatings have specific cleaning instructions or products that you should receive from the fitter. You may allow your child to personalize their eyeglass case.

There is usually an adaptation period for any new pair of glasses. Initially, your child may resist wearing the glasses as he or she may feel that their vision is not clear or things look a little funny. With continued wear of the glasses, as directed by your Doctor of Optometry, these symptoms should resolve. However, any problems that persist beyond one or two weeks should be reported to your Doctor of Optometry. To encourage your child to wear his or her glasses, make it a part of their daily routine. Also, remember to make your child’s teacher aware of the wearing schedule of the glasses.

Recipe - Butternut Squash Flat Bread With Cheddar and Pine Nuts

A diet that's high in beta-carotene may help delay visual loss caused by some forms of age-related macular degeneration, the most common cause of severe vision loss in Canada. Squash is one eye food loaded with beta-carotene! We like squash soup for the colder months; how do you like to eat squash?

Here is a recipe for delicious Butternut Squash Flat Bread with Cheddar and Pine Nuts!

Serves 4

Ingredients

1 

pound 

store-bought pizza dough, thawed if frozen

cornmeal for the pan

1 

pound 

butternut squash—peeled, seeded, and sliced 1/4 inch thick

1/2 

red onion, thinly sliced

1/4 

cup 

pine nuts

1 

tablespoon 

fresh thyme leaves

2 

tablespoons 

olive oil

kosher salt and black pepper

1 1/2 

cups 

grated extra-sharp Cheddar (6 ounces)

1 

bunch 

arugula, thick stems discarded (about 4 cups)

Directions

1. Heat oven to 425° F. Shape the dough into a large oval and place on a cornmeal-dusted baking sheet.
2. In a large bowl, toss the squash, onion, pine nuts, thyme, 1 tablespoon of the oil, ½ teaspoon salt, and ¼ teaspoon pepper.
3. Scatter over the dough and sprinkle with the cheese. Bake until golden brown and crisp, 20 to 25 minutes.
4. Toss the arugula with the remaining tablespoon of oil and ¼ teaspoon each salt and pepper. Serve with the flat bread.