Introduction
Eye patching is a treatment for amblyopia or lazy eye. For children with normal vision, the brain develops the ability to use both eyes during the first months of living. However, for children with amblyopia, the brain ignores or blocks the eye with inferior vision, and it prefers the eye with good vision.
Since this action happens at a very early stage in life, the lazy eye does not develop.
Patching is done to encourage the use of the weaker eye by covering the right eye. This treatment is mainly done in young children. It is recommended for the treatment to be done early to strengthen the weaker eye.
Before the Procedure
The eye doctor will first determine the duration of patching based on the child's age, cause of amblyopia, and severity levels of the sickness.
Patching does not need to be done in one stretch in a day. The child and parent can agree to split the it into two sections depending on the comfort levels. For instance, if the required patching time is two hours, the child can have the patch on for one hour in the morning and another hour during the evening.
Procedure
In patching, a cover is placed on the healthy eye to limit any visual input hence forcing the brain to use the weak eye. With the good eye being covered, the lazy eye has to engage in games /activities that require coordination between the hand and eye. Through this action, the amblyopic eye slowly enhances its vision and development in the brain.
A child's good eye can be patched with various techniques. They include:
- Ready eye patch - It contains a self- adhesive layer.
- Tissue paper folded and placed on the eye using meditape
- A soft cloth worn over the eye - It resembles a pirate eye patch
The good eye must be well blocked, and the child should not see from the sides or peep above the patch. On average, patching therapy may be required for a few months to a few years.
Although patching is a struggle for young children, postponing the treatment by a few years may be risking the child's eyesight. Vision develops fastest in the early years of life, and the brain has a sensitive period of about 8-10 years, where it responds well to patching. Any age past this poses a risk for developing poor vision over adult life.
Risks & Complications
Patching is considered a safe treatment. However, the parent or caregiver should consider some side effects such as skin reactions due to the adhesive patches. The rashes are however only external and can be treated using an alternative patch material.
The caregiver can also try placing a thin transparent fabric, larger than the patch, around the eye area before putting the patch. They should then trim some of the adhesive, so that very little of it touches the skin. The patch ought to completely cover the normal eye and stays perfectly in place.
Alternatively, the child can use patches that are placed on glasses. These forms of patches assist in curbing skin irritation while providing good eye coverage. For ultimate effectiveness, the glass frame needs to have a structure that inhibits side vision and prevents the child from seeing around the patch.
Applying lotion to the affected area should also help reduce any irritations.
Aftercare & Recovery
Having the child wear the patch can be very uncomfortable. S/he may be resistant to wearing the patch at initial stages. The caregiver should therefore start with short periods and increase the timings slowly for better results.
Since wearing the patch is not enjoyable, spending time with the child during treatment is likely to ease the transition process. Activities such as reading, coloring, painting, crafting, playing catch, and solving puzzles can exercise the lazy eye. Children will usually start to accept the patch when the vision in the weaker eye improves.
Patching schedules ought to be strictly followed, and regular follow-up visits are mandatory. Total recovery may take a few weeks to some months.
Outcome
The expected outcome after patching treatment is an improved vision in the formerly weak eye.
When not done correctly however, a child may experience reverse amblyopia. The amblyopic eye may get better while the eye with a good vision takes on the lazy traits. It is then essential to have regular follow-ups where a doctor can monitor the child's progress and prevent the stronger eye from becoming amblyopic.
