A common treatment for amblyopia is patching to help the “weaker eye” work stronger by occluding or patching “stronger eye.” This forces the brain to interpret visual signals from the weaker eye, which forces the brain to develop neurons which are dedicated to interpreting the weaker eye’s signals.
What is amblyopia?
A common vision problem in children is amblyopia, or “lazy eye.” It is so common that it is the reason for more vision loss in children than all other causes put together. Amblyopia is a decrease in the child’s vision that can happen even when there is no problem with the structure of the eye. The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry with that eye, even when glasses are used. If it is not treated, it can cause permanent loss of vision because the brain will gradually tune out that eye’s input, and then eventually ignore it completely.
When should patching begin?
Patching should begin as early as possible. When first applying your child’s patch, explain the reason for the patch being used. It may be helpful to demonstrate on a doll. If the child attends school or pre-school, explain the patching treatment and schedule to the child’s teacher. 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 to 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 the 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 the doctor may recommend that this treatment be discontinued.
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 shirt works well.
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.
Download a PDF publication by Burton J. Kushner, MD
The John W. and Helen Doolittle Professor of Ophthalmology University of Wisconsin Department of Ophthalmology and Visual Sciences, Madison, WI.
“Imagine that you suddenly noticed your six month old daughter’s right eye momentarily crossed inward toward her nose. It only lasted a few seconds, so perhaps you were not certain it really happened. Then her eye turned in again. After a few days this began to occur with increasing frequency, and her eye stayed crossed in for longer periods. After discussing the problem with your family doctor or pediatrician, he suggested you see an eye doctor…”
Supported by an unrestricted grant from Research to Prevent Blindness, Incorporated, New York, NY