Patching

Patching, or occlusion, is done in childhood to treat amblyopia, or a lazy eye. It works by stimulating the poor eye and thus developing better sight.

Your orthoptist will recommend how much patching should be done. This will be based on the level of vision, the cause of the amblyopia and the age of the child. It is usually best to use an adhesive patch that sticks onto the face, to ensure that there is no peeking. If glasses are worn, they should be worn over the patch.

Most types of adhesive patches are hypoallergenic. However, a skin reaction is still possible. If this occurs, try a different brand, or your orthoptist may recommend a non-adhesive 'extension' patch. Alternatively, Atropine therapy may be advised.

Patching is never easy for the child (or the parent!), particularly when the sight in the amblyopic eye is very poor. However, there are ways to make it easier, for both the child and the parent. Coloured patches are now available and are often preferred. Simple star charts can be a valuable means of encouragement. Use a patch that peels off painlessly, or merely 'tickles'. Many people find it best to patch at the beginning of the day as part of the daily routine. In older children, they may be too self-conscious to wear the patch at school, but it can work well in younger children.

Reward charts can be a really effective way of encouraging children to wear their patch every day.

When patching, any activity that uses the eye is effective, possibly the more detailed the better, for example, drawing, reading, using a computer, or even watching TV. This can work particularly well as it distracts the child and stops them from thinking about the patch.

Remember that the younger the child the more effective the treatment, but one of the most common reasons for the treatment not working is poor compliance.