What is patching?
Patching is a technique for treating amblyopia (lazy eye). The good eye is covered to encourage the development of the lazy eye. Amblyopia can be caused by unequal refractive errors, crossed eyes, misaligned eyes (strabismus), or other abnormalities.
When should treatment begin?
Patching should begin as early as possible. When first applying your child’s patch, explain the reason the patch is being used. It may be helpful to demonstrate the patching on a doll. If the child attends school or pre-school, explain the patching treatment and schedule to the child’s teacher. Enlist the teacher’s help in encouraging the child to perform his usual tasks, while making allowance for added difficulty. The teacher can also help explain the child’s situation to classmates.
How long will a child need to wear the patch?
This will vary with each individual child. As a general rule, the younger the age of the child and the shorter the time the eye has been lazy, the less time it will take for treatment. In young children vision may change rapidly.
Occasionally, vision in the good (patched) eye may be decreased when the patch is removed, but will usually return to normal as soon as that eye is used again. To ensure that a child is given the best possible chance to develop normal vision, patching may be continued for a few weeks or months after vision stabilizes. Once vision has improved in the lazy eye there is a small chance that it can worsen again, and close monitoring is necessary throughout childhood. If the vision does not improve after a reasonable period of effective patching, your ophthalmologist may recommend that this treatment be discontinued.
Will patching correct misaligned eyes?
No. Usually patching improves vision in the amblyopic eye but does not change misalignment of the eyes. Once vision is good in each eye, your ophthalmologist can recommend treatment for realigning the eyes.
What kind of patch should be used?
The patch should be comfortable, should remain firmly in place, and should not allow any peeking around the edges. Commercial patches come in “regular” and “junior” sizes and are available at most drugstores. A gauze pad held firmly in place with hypoallergenic tape can also serve as an adequate homemade patch. Black eye patches with elastic or ties and occluders which clip onto glasses are not recommended as they may allow peeking. The patch should be attached directly to the skin around the eye for best results.
What should be done if the skin becomes sore or irritated?
Leave the patch off at night and try a different type of patch. Change the shape of the patch by reversing its position on the eye. Switch to a gauze pad and hypoallergenic tape. If glasses are worn, make a “wrap around” patch on the glasses until the skin has healed.
What if the child removes the patch?
For young children, applying extra tape over the patch is often enough to secure it. If your child still succeeds in dislodging the patch, you may need to cover his or her hands with mittens. Tube socks that extend over the elbow under a long sleeved t-shirt work well. A last resort are splints rolled up paper taped inside the tube sock to prevent the elbow from bending, thus keeping the hands from the face.
For older children, wearing a patch to school may create psychological problems. Wearing the patch when not in school or on weekends can obtain good results, but the improvement may take longer.
In today market you will find many helpful tool such as books, DVD’s, colored patches, that will make it more appealing for your child to go through this process.
Will exercises help?
The best exercise is wearing the patch! Fine, detailed work which holds the child’s interest will also encourage use of the lazy eye and speed visual recovery.
American Academy of Ophthalmology
The Eye M.D Association