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Patching of one eye is done to force the use of the other eye.
Usually the other eye is visually “lazy”. Sometimes patching is also
used to force the opposite eye to extend its range of motion.
Patching may be used to force the brain to pay attention to the
position of the other eye.
Amblyopia is the term used to describe visual “laziness.” Amblyopia
treatment is extremely important. The younger the child, the more
rapid the response. Amblyopia treatment is unproductive in children
over nine years and in some children is ineffective after six or seven
years old.
An
eye may become visually lazy because of suppression (the brain
“ignores” the image from one of the eyes) in order to eliminate double
vision that results from misalignment of the eyes. An eye that is
slightly misaligned may become more misaligned after the patching is
begun. We mention this so that this event will not cause the parents
great distress. A misalignment of the eye can be dealt with more
easily than the vision loss.
Patching must be monitored. The eye under the cover can become the
weaker eye in an unsupervised situation. The goal of patching is
equal vision in the two eyes. In addition each child’s situation is
unique and patching regimens vary greatly. There is not a “one size
fits all” approach.
Children do not like to be patched. They don’t even like to wear
clothes sometimes. The more intense the amblyopia, the more difficult
it is to get a child to accept the patch. Parents have to equate
patching to the treatment of an injured eye. An amblyopic eye not
stimulated can suffer visually just as much as an eye that has been
injured, in some cases even more. Amblyopia therapy is so important
that the child should be restrained if necessary to prevent removal of
the patch. This may seem cruel to the parents but in this case the
ends justifies the means. Patches will adhere better when the skin
beneath the adhesive if the skin is prepared by painting with Tincture
of Benzoin. Excessive irritation produced by the patch may require
the use of different types of materials. A simple home remedy for
skin irritation involves painting a thin layer of Mylanta on the skin
to be patched (with care to avoid the eye). Allow the Mylanta to dry
fully before applying the patch.
Please accept this challenge on behalf of your child’s eyesight. It
is a most worthy investment of your time. Please call our office for
any additional questions or support!
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