Patching is recommended when children are diagnosed with amblyopia or lazy eye. It works by occluding the eye with normal vision so that the vision in the poorer seeing, amblyopic eye improves. Patching is used to improve vision. It rarely improves a misalignment of the eye that causes the vision to decrease in the first place. Many Pediatric Ophthalmologists treat patients with Amblyopia and Strabismus by first patching the good eye to improve the vision in the with poor vision and then doing strabismus surgery on the eyes to improve the alignment.
It is oftentimes extremely difficult to patch a child. Most young children do not understand why we are patching their good eye as they simply cannot see with the patch on. They do not understand that the vision will improve with time. Children with adhesive patches may try to peel them off and children with felt patches may try to peek around the patch. It is important for parents and caregivers to be persistent and strict with their children to encourage compliance. In this circumstance, I feel it is O.K. to have these children play with their iPads and computers to distract them. These devices also are visually stimulating and may increase the vision more quickly. Bribery can also work to encourage compliance. I encourage the parents of my patients to give their children a special treat each week to reward their children for good patching. The special treat could just be an extra ice cream cone or toy. Many of my patients have designed their own incentive charts at home. There are many websites that are available such as patch pals.com, which have incentives to patch.
The only patches to my knowledge that are sold over the counter are bandaid-like patches. They can be irritating to the skin and aren’t as “fun” as many of the patches sold on the internet. The patches we use in my office are called Ortopad patches but there are many websites that offer fun patches. I prefer the adhesive patches as they are more difficult to peek with. The felt patches, however, are a good alternative, especially when a patient has sensitive skin. They also come in a lot of fun designs.
Patching is an essential treatment for amblyopia. Since amblyopia frequently isn’t treatable past the age of 9, it is extremely important for parents and caregivers to be persistent about patching and not wait until their child is old enough to understand the consequences. Seeing the face of a child and their parent when they reach 20/20 is indescribable. It is worth every difficult moment!