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:
- 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
- age (in general the younger the child and the earlier treatment is started, the less time it should take to improve vision)
- 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 is no particular activity that will improve the vision more than another activity. The most important part of treatment is keeping the patch on for the prescribed treatment time. Some eye doctors believe that the performance of near activities (reading, colouring, hand-held computer games) during treatment may be more stimulating to the brain and produce better or more rapid recovery of vision.
SHOULD PATCHING BE DONE DURING SCHOOL HOURS?
There are often questions about whether children should patch at school or at home: this should be decided on an individual basis. In many instances, school is an excellent time to patch, taking advantage of a non-parental authority figure. Patching during school hours also gives the class an opportunity to learn valuable lessons about accepting differences between children. If the patient, teacher, and classmates are educated appropriately, school patching need not be a socially stigmatising experience. On the other hand, frequently a parental or other family figure may be more vigilant in monitoring patching than is possible in the school setting. Parents should be flexible in choosing when to schedule patching.
WHAT IF MY CHILD WON’T KEEP THE PATCH ON
The ophthalmologist will give the instructions and monitor the progress but the patient and the family will need do the hard work of actually performing the treatment. Children do not like to have their good eye patched, especially if the vision in the amblyopic eye is very low, but parents must stand by them and help them do what’s best. Parents play probably the most important role in a successful treatment. 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.
More "forceful" measures can be considered if your child refuses to wear the patch, but these should be discussed with your doctor.
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.
IS THERE AN ALTERNATIVE TO PATCHING TO TREAT AMBLYOPIA?
Sometimes the stronger eye can be “penalised” by using eye drops such as atropine. Atropine temporally blurs the vision in the good eye and works as an alternative to patching in selected cases of mild to moderate amblyopia. Not all children benefit from eye drop treatment for amblyopia. Penalising eye drops do not work as well when the stronger eye is nearsighted or when the degree of amblyopia is severe. Atropine is also not without potential side effects.
CAN SURGERY BE PERFORMED TO TREAT 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. Children who are born with cataracts may need surgery to take out the cataracts. After surgery, the child will
usually need vision correction with glasses or contact lenses and patching.