Patching is sometimes 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. .
An orthoptic patch with adhesive on the back is best. It looks like a Band Aid [See figure 1]. The patch should be large enough to cover the child's eye completely. Some adhesive patches are made with colorful designs that encourage the child to wear the patch. Cloth patches that fit over the child's glasses are also available. In order for the cloth patch to work effectively, the glasses must be fit well on the face and there must be no peek holes around the patch. Pirate patches are usually not effective because they do not fit tightly enough to the child's face and there are peek holes.
Yes. The glasses should be worn over the adhesive patch. Do not stick the patch on the glasses lens. It will not be effective.
Lubrication of the skin after patch removal is helpful. Different brands of patches use different adhesive, so changing the brand of patch may help reduce skin irritation. Another trick is to paint Milk of Magnesia liquid on the skin covered by the patch. Allow the liquid to dry and then apply the patch. The dried powder helps minimize the contact of the adhesive with the skin.
Making patching a consistent part of the daily routine is helpful in encouraging younger children to patch. One on one playtime with an infant or toddler may be the best approach to ensure the child does not remove the patch. Offering a preferred activity (favorite TV show, video games) while patching can be helpful. Sometimes caregivers use Velcro wraps around the arms of infants and toddlers to prevent patch removal. Usually the "no-no's" need to be used just a few times to encourage compliance.
Older children may need to be rewarded for good patching compliance. A calendar with stars placed on it for each episode of successful patching is motivating to some children.
Revised November, 2012
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