Infants may at first appear blind but later develop characteristic head movements to shift gaze (head thrusts). Typically the abnormal head movements subside as the child learns to make blinks to help move the eyes, which can make detection of the condition difficult in the older child. Most children with congenital ocular motor apraxia have few problems getting around. They can have problems with looking in a particular direction and following fast moving objects (such as following a ball in sport or watching cartoons on television).
Children may be hypotonic (floppy) with mild motor delay (behind in developing motor skills such as holding head up, rolling over). There may be some unsteadiness of movement called ataxia. Speech development may be slow requiring speech therapy, and reading problems may occur.