Pediatric Pearls: Infant's Eye Part 1 - Red Spots, Puffy Eyes, Big Eyes

April 2, 2023

Pediatric Pearls is usually behind a paywall but I thought I would send this out to everyone so you all can have a look. Part 2 of The Eye will be posted in two days, on Wednesday, April 5.

1. A parent asks, “My baby has a red spot in her eye. What is that?”

After birth, many infants have a red spot or red patch in the white part of the eye. This is most likely a subconjunctival hemorrhage. This is caused by a tiny blood vessel breaking just underneath the clear surface of the eye, often due to the pressures exerted during labor. The red spot is always confined to the limits of the sclera (the white part of the eye). This is harmless and resolves with time.

2. A mother asks, “I can’t see my baby’s eyes because her face is so puffy. Is this ok?”

Again, in the first few days, a healthy infant can look puffy due to the pressures exerted during labor. This should resolve over the one to two days.

Here is my granddaughter on day one of life. Look at her puffy eyelids and puffy face.

3. Do babies have big eyes? Yes, a fun eye fact is that babies do have big eyes. The size of a newborn’s eye is about 2/3 of the way to full adult size.

Big eyes are thought to be one of a group of “cuteness traits.”

In 1943, an Austrian ethologist, Konrad Lorenz, proposed kindchenschema, “cuteness traits,” to explain why we find babies cute. He suggested there are actually some traits that babies possess that automatically trigger our brains into feeling a sense of joy.

Cuteness traits include:

• A large rounded head

• A big forehead

• Large eyes

• Chubby cheeks

• A rounded body

• Soft, elastic skin.

According to Lorenz, this is an evolutionary tactic to get us to take care of babies that otherwise can’t do anything for themselves.

Here is my granddaughter again, this time at 3 months. She has big eyes and many other cuteness traits, in my very biased opinion.