Patching is sometimes recommended to treat amblyopia or "lazy eye". By covering the "good" eye (or the eye with better vision), the brain is forced to use the "weaker" amblyopic eye.
This helps the neural pathways or "connection" between the eye and the brain to develop better vision.
An orthoptic patch with adhesive backing is the most effective. The patch should be large enough to cover the child's eye completely. It should be firmly applied so that it is not easy for the child to find an opening and "peel" it off. There are many brands on the market, including Coverlet and Opticlude, which are flesh colored and look like a Band Aid. These can be purchased in any pharmacy. There are also many brands of "decorated" patches which sometimes make the process of patching more fun for the child. One brand is Ortopad, which can be ordered online or over the telephone. (We have a supply of these in our offices for your convenience.) The adhesive properties can vary between brands, so feel free to try a different brand if one is not working well. If the adhesive irritates the skin, applying “Milk of Magnesia” to the skin that the adhesive contacts, prior to placement of the patch, can be helpful.
There are several brands of cloth patches that slide over glasses which can be used for some children. Children are much more likely to "peek" around these patches, so check with your ophthalmologist about whether this type of patch would work for your child.
A Bangerter filter or opaque plastic film can also be used on the glasses if your physician feels this would be an appropriate treatment for your child. These may be purchased in the physician's office.
Pirate patches are usually NOT effective because they do not fit tightly and it is easy to "peek".
There is no doubt that the process will take patience, persistence and determination. Commitment to patching on the part of the parent is critical. The message to the child needs to be "there are no options". Just as a child may not like to ride in a car seat, or wear a seatbelt, the parent must insist for the child's well being. The rule should be that only a "grown up" such as mom, dad, grandparent, nanny, etc. may remove the patch.
Choose a time of day when the child is not tired or hungry. Making patching a consistent part of the daily routine is helpful in encouraging a child to patch. One on one playtime may be necessary at the beginning for encouragement and support. It will be difficult for the child to see when you first put the patch on, and they will be easily frustrated. Offering a preferred activity while patching can help motivate the child. ("We will put the video on once the patch is on.") Establishing a reward system for successful patching (stars on a calendar, a small favorite treat to eat) can be helpful for older children. Distract younger children with activities that keep their hands busy. If the child pulls the patch off, simply put another one on and introduce a new activity. Be patient and understanding, but firm and consistent.
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