Patching

Patching of one eye is done to force the use of the other eye.  Usually the other eye is visually “lazy”.  Sometimes patching is also used to force the opposite eye to extend its range of motion.  Patching may be used to force the brain to pay attention to the position of the other eye.

Amblyopia is the term used to describe visual “laziness.”  Amblyopia treatment is extremely important.  The younger the child, the more rapid the response.  Amblyopia treatment is unproductive in children over nine years and in some children is ineffective after six or seven years old.

An eye may become visually lazy because of suppression (the brain “ignores” the image from one of the eyes) in order to eliminate double vision that results from misalignment of the eyes.   An eye that is slightly misaligned may become more misaligned after the patching is begun.  We mention this so that this event will not cause the parents great distress.   A misalignment of the eye can be dealt with more easily than the vision loss.

Patching must be monitored.  The eye under the cover can become the weaker eye in an unsupervised situation.  The goal of patching is equal vision in the two eyes.  In addition each child’s situation is unique and patching regimens vary greatly. There is not a “one size fits all” approach. 

Children do not like to be patched.  They don’t even like to wear clothes sometimes.  The more intense the amblyopia, the more difficult it is to get a child to accept the patch.  Parents have to equate patching to the treatment of an injured eye.  An amblyopic eye not stimulated can suffer visually just as much as an eye that has been injured, in some cases even more.  Amblyopia therapy is so important that the child should be restrained if necessary to prevent removal of the patch.  This may seem cruel to the parents but in this case the ends justifies the means.  Patches will adhere better when the skin beneath the adhesive if the skin is prepared by painting with Tincture of Benzoin.  Excessive irritation produced by the patch may require the use of different types of materials.  A simple home remedy for skin irritation involves painting a thin layer of Mylanta on the skin to be patched (with care to avoid the eye).  Allow the Mylanta to dry fully before applying the patch.

Please accept this challenge on behalf of your child’s eyesight.  It is a most worthy investment of your time.  Please call our office for any additional questions or support!