Videos for the review article

Videos for the review article in Current Ophthalmology Reports, published by Springer: Current understanding of what infants see by Hyvärinen L, Walthes R, Jacob N, Nottingham Chaplin K, Leonhardt M. DOI:10.1007/s40135-014-0056-2.

Video 1. A and B. Delay in accommodation development

If an infant is referred from the basic health care to an ophthalmologist, sometimes the problem is solved in a few seconds, as in this case when an otherwise normally developing 4-month-old infant refused to look at the face of her mother (Video A). Usually bringing hands to the midline brings the gaze to the midline. In this case even this strategy did not work.

Video 1. A.

The infant was easy to assess because she did not accommodate or converge. Her refractive error was +1 in both eyes. Consequently, the image of the mother’s face at the level of the infant’s retina was blurred and double. When +4 diopter (+3 for the 30 cm distance of the mother’s face and +1 for the refractive error) reading glasses were placed in front of the baby’s eyes, for a moment she was surprised, then she looked at her mother’s face, converged briefly, and then apparently fused the images and smiled at her mother for the first time. In the video you can hear the joy in the mother’s voice when her child looked at her and smiled for the first time (Video B).

Video 1. B.



Video 2. Hands and Motor Functions

Starting in the 1st month of life, it is possible to observe that some infants look intensively at a hanging toy and then hit it repeatedly with a targeted arm and hand movement. Such activity gives infants information on how far they can reach with their hands and is one of the cornerstones in learning to understand egocentric small spaces. The infant in this video is a healthy 8 weeks old visually active baby who has trained arm and hand functions so that the movement to hit the hanging toy was nearly every time successful.



Video 3. Recognition of faces and age appropriate visual communication

The fourth visual milestone is observable at the age of 7 to 10 months and includes recognition of parents’ and caregivers’ faces and the ability to see the difference between well- and less-known faces of individuals before they say something to the child. Infants have usually developed good visual communication, which we can observe in this short video sequence:

  1. A short look at the tester as if asking “I can have this ball?”
  2.  An equally short but clear confirmation from the mother that the infant is doing everything correctly.
  3.  A short look at the father outside the picture. Correct copying of the pressing of a small button to change the color of the ball shows good eye- hand coordination.

In less than a minute we have seen age-appropriate, good visual communication and well developing hand functions. This infant has no difficulty knowing who the individuals near him are, even if the parents did not say anything.



Video 4. Playing with puzzle at the age of 18 months

At the age of 1 year, infants become interested in simple puzzles and may even have one-syllable names for the puzzle pieces. At the age of 18 months, infants may play with puzzles that require good form perception. This 18-month infant seems to tell her parents how the puzzle should be used.



Video 5 A. and B. Training for measurement of visual acuity

The LEA Puzzle is an educational toy, as well as a neuropsychological test situation where we can observe the development of the concept of “same”. Infants begin to understand “same” when playing on the colorful side of the puzzle and become accustomed to forms of the puzzle pieces. At this stage they can move to black-and-white forms. During the play, we can follow the development of eye-hand coordination and recognition of orientation of objects in space when the infant starts to rotate the wrist for turning the puzzle piece in correct direction before touching it. If we entice the infant to look away from the puzzle, we can turn the puzzle board and observe short-term memory for localization: the child moves the hand to place a puzzle piece in the corner where its cut-out was a moment ago, stops in midair, searches for the correct cut-out, and places the piece in its cut-out – or the child tries to push the puzzle piece with force into the wrong cut-out.

When the use of concrete forms becomes easy, the puzzle pieces can be compared with their pictures. Each picture should be large enough to surround the matching puzzle piece. When this comparison is easy, the pictures can be smaller cards in the LEA Playing Cards test, at which time we are measuring binocular visual acuity in near vision, the most important distance for communication and learning.

Video 5. A.

The 26 month-old child pictured above had started to use names for the puzzle pieces and spontaneously used them. If naming is easy, we may use the names the child has chosen. Otherwise, the test situation is best used as purely visual matching with puzzle pieces instead of an answering card.

Video 5. B.