Dear Parent/Guardian: Your child has been found to have reduced vision in one eye. This is called Amblyopia. His/her treatment will require patching.

What Is Eye Patching?

Eye patching is a treatment for amblyopia or lazy eye. This is a condition when one eye does not develop normal eyesight. Patching of the dominant (good) eye helps the weak eye get stronger. The treatment can work very well when patching instructions are carefully followed. The best time to use eye patching to correct amblyopia is during early childhood (the earlier the better).

Why Do I Need To Patch?

Patching is a technique used to treat amblyopia (also known as ‘lazy eye’). Amblyopia develops when one eye is used more than the other. This causes the other eye’s vision to be weak or poor. Patching the good eye forces the use of the weak eye and encourages the development of better vision.

Glasses may also be prescribed to treat any focusing problems, but patching may still be required to treat the amblyopia. Amblyopia cannot be corrected with surgery. Surgery may be performed to straighten the eyes, and patching may still be required before and/or after surgery. If amblyopia is not treated, it may result in a permanent and serious visual loss in one eye, it may affect depth perception, or it could result in a lifetime of poor vision if the good eye becomes diseased or injured.

What Kind Of Eye Patch Should My Child Use?

The best kind of eye patch is an orthoptic patch with adhesive on the back (similar to a plaster). You should put the patch directly on your child’s skin around his/her strong eye. Some children are sensitive to the adhesive. If your child has this problem, you can try a few things including:

Tips

  • Make sure you are not leaving the patch on overnight.
  • Use a warm facecloth or sponge to wet the patch before removing it.
  • Switch to a different brand of adhesive patch.
  • Cut various holes or sections from the adhesive portion of the patch. Ensure the patch remains secure and doesn’t allow peeking.
  • Try ‘pre-sticking’ the patch to clothing or your arm to reduce the amount of adhesive before applying.
  • Apply a thin layer of ‘milk of magnesia’ to the area of skin to which the patch is applied. Let it dry and then attach the patch to this area. This will protect the skin and enable the patch to come off easily.
  • If all else fails; you can try an alternative form of patch rather than the adhesive type.

Another type of patch is made of material. This can be used over glasses but in order for this type of patch to work well the glasses should fit tightly and the cloth should not have any holes.

How Long Will My Child Need To Patch?

The amount of patching therapy required is different for each child. Your child’s vision may improve a few weeks after starting patching but it may take many months for the best results. There are many factors that can influence the amount of treatment needed. Some of these include: age (in general the younger the child and the earlier treatment is started the less time it should take to improve vision) and severity (some types of amblyopia are more difficult to treat than others).

Your doctor or therapist will prescribe either full-time or part-time patching of the stronger eye during the day. Once vision has improved or stabilised, patching will be tapered slowly to prevent relapse. Sometimes the vision in the weaker eye can deteriorate and the amount of patching may need to increase again, because of this it is important to have vision checked on a regular basis. Unfortunately not all children’s vision will improve with patching. After a reasonable period of compliant patching it may be advised by your doctor to stop patching.

When Should My Child Wear An Eye Patch?

Your child should wear the patch during the daytime when he/she is awake. There are often questions about whether children should patch at school or at home: this should be decided on an individual basis.

What if my child won’t keep the patch on?

It is very common for children to refuse to wear an eye patch. Successful treatment mostly depends on your commitment, involvement and ability to gain your child’s cooperation. It DOES get easier; don’t give up too soon! It may take a lot of encouragement from family, friends and teachers for your child not to remove the patch.

Here are a few tips:

  • Consider rewarding your child if he/she keeps the patch on for the full amount of time. Make a large reward calendar.
  • Let your child choose the colour and pattern of his/her eye patch.

  • Try patching during your child’s favourite activities. Some kids are more willing to wear patches while they are watching TV or playing games.
  • It may help to start slowly; high levels of patching early may induce frustration. Ask your doctor if you can gradually add an hour a day or week.
  • Use positive reinforcement and avoid negative reinforcement or power struggles

  • Use a timer to indicate when the patch comes off.

  • Consider having a rule that only parents or caregivers can touch the patch.

If your child still refuses to wear the patch more “forceful” measures can be considered but this
should be discussed with your doctor or therapist. There are occasionally times when patching continues to be impossible and you may have to accept that one eye will always be poorer than the other. It is always reassuring to know that you have done everything you possibly can with patching before accepting this. For more information please see “amblyopia”