Eye Health Center

Key Points

Amblyopia is a vision problem that occurs in a child when one eye is not used enough for the visual system in the brain to develop properly. This leads to poor vision in the affected eye.

• Treatment corrects amblyopia by training the brain to use the eye with weaker vision. This allows vision to develop normally in that eye.
• Covering the stronger eye with a patch is the most common method of treating amblyopia.
• To be effective, an eye patch must be worn as directed by your doctor.
• By providing support and reassurance, you can help your child comply with the patching treatment so that he or she can develop the best vision possible.

Amblyopia is usually treated by an ophthalmologist.

Treatment with an eye patch corrects amblyopia by training the brain to use visual signals from the eye with weaker vision. This encourages the brain to process what that eye sees. It helps build a stronger connection between the brain and the weak eye and allows vision to develop normally in that eye.

If your child must wear a patch, the doctor will tell you when and for how long. Stay on the schedule. Try to prevent your child from taking off the patch or looking around it. Wearing a patch can be difficult and uncomfortable, especially for young children. They may be confused or afraid about wearing the patch, and other children may tease them.

By giving direction, motivation, support, and reassurance, you can help your child comply with the patching treatment so that he or she can develop the best vision possible. Do this by telling your child why the treatment is needed and giving him or her clear guidelines on when and how long he or she must wear the patch. Encourage the support of family, friends, teachers, and classmates.

To be effective, an eye patch must be worn as your doctor directs and for the full time period. It is important for you to help your child comply with the patching treatment so that he or she can develop the best vision possible. Not wearing the patch as directed is the major cause of failure in the treatment of amblyopia.

Early treatment for amblyopia can usually reverse the condition. Treatment is best started before age 6 and should begin before your child's vision has fully developed, which is around age 9 or 10. In general, the younger the child is when treatment begins, the better his or her chances are for having good vision.

Help your child understand why the patch is needed. Reward, support, and reassure your child. This will help your child comply with the patching treatment so that he or she can develop the best vision possible.

Here are some of the things you can do to help your child wear the patch and to help make the treatment more effective.

Provide information

The more your child and the people around him or her know about the patching as a treatment for amblyopia, the more successful the treatment is likely to be.

• Talk to your child before treatment begins. Explain that the patch is needed to help make vision in the affected eye stronger.
• Explain to family and friends why your child is wearing the patch and how important it is that the patch stays on. Ask them to be supportive. Offer suggestions on ways they can help make the treatment successful.
• If your child is in day care or school, talk with his or her caregivers and teachers. Often they will be glad to explain to your child's peers and classmates why he or she is wearing the patch and how they can help your child's treatment be successful. This can help your child feel more comfortable about wearing the patch at day care or in school.

Set clear ground rules

Set clear guidelines and establish realistic expectations for wearing the patch. These will help you and your child avoid a power struggle or a battle of wills over wearing the patch. Your child will probably do better if he or she understands when and how long the patch must be worn.

• Your doctor will tell you when your child must wear the patch and for how long. Explain the schedule to your child, and stay on it.
• Make it clear what the consequences will be if he or she removes the patch. And tell your child about the rewards for keeping the patch on without complaints or difficulties.
• You may wish to set up a rule that only parents (or caregivers and teachers) can touch the patch when it is on.
• If your child is to wear the patch only part of the time, use a clock or a timer to mark when the patch is put on-and when it can come off. This will give your child some well-defined limits and can also help avoid making you the "bad guy" for making sure the patch stays on for the required time.
• Use a day planner or a calendar to show your child when and how long to wear the patch and to keep track of his or her progress. Let your child mark each time a patching session is completed. This can provide a visual "map" of the treatment and how much of it he or she has accomplished.

Be supportive

Wearing a patch can be difficult and uncomfortable. By giving support and reassurance, you can help your child comply with the patching treatment.

• Amblyopia is commonly called "lazy eye." Reassure your child that despite the nickname, an eye with amblyopia is not actually lazy and that he or she has not done anything wrong. A child with amblyopia may not even know that he or she is using only one eye. Ignoring the image from the weak eye is the brain's unconscious response, not the child's decision. Your child has no control over this process.
• Schedule the times when your child will wear the patch. It may be possible to wear the patch only at home. Then your child can avoid any hurtful comments or teasing that may happen because of the patch.
• Consider giving rewards when your child wears the patch without complaints or difficulties. You can use a day planner or a calendar to show your child's progress toward the reward.
• Encourage support from family, friends, and classmates. Offer suggestions on ways they can help make the treatment successful.
• Other children might make fun of a child who has to wear a patch over one eye. Comfort your child, but remind him or her why it is important to keep the patch on.

Try to have some fun

Wearing an eye patch is not enjoyable. But there are some things you can do to make the times your child is wearing the patch more fun and to help make the treatment more effective.

• Spend time with your child just after the patch is put on. It takes a short time-about 10 or 15 minutes-for the brain to adjust to having the dominant eye covered. Doing something fun during this time can make the transition easier.
• Give your child as much one-on-one attention as possible while he or she is wearing the patch. Your child will enjoy the time you spend together, and this will help take his or her mind off the patch. Try to find games and activities that capture your child's attention and make the affected eye work harder.
• If your child is wearing adhesive-type patches, let him or her decorate them. Check with your doctor to see if crayons, markers, stickers, or other kinds of decorations are acceptable and how to apply them. Decorating a patch can make your child feel better about wearing it, especially when he or she finds that family, friends, and classmates like the decorations too. Be careful not to put any decorations on the side of the patch that faces the eye.

Make the weak eye work

Patching treatment for amblyopia will be more effective if your child's weak eye has to work harder while the normal eye is patched. Games and activities that require visual acuity and eye-hand coordination work well.

• Start with simple activities. At first, your child's coordination may not be good because the brain is still learning how to use the weaker eye. Easy activities will help build your child's confidence.
• Coloring books, paint books, and crafts such as cutting and pasting are all fun activities that require good eye-hand coordination.
• Tossing beanbags or small balls (such as ping-pong balls) into buckets or other containers can be a fun and challenging activity. Keep in mind that with one eye patched, your child's depth perception will be reduced, and he or she may have some difficulty with toss games.
• Picture books and reading require close visual attention. Even if your child is not reading yet, looking at the pictures in children's books is a good way to make the weak eye work during patching. Spend time reading and looking at books with your child. Have your child look at the details of the pictures. If he or she is learning to read, help the child work through the text.

Help reduce irritation

Patches may irritate the skin around the eye and may cause a light rash. Patches on elastic bands may rub because they move more freely than adhesive patches. Adhesive patches are preferred because they cover the normal eye more completely. But adhesive patches may also irritate the skin. Talk to your doctor if your child gets an irritation or skin rash.

• Try using a hypoallergenic adhesive patch, which is less likely to cause irritation.
• Skin ointments or lotions can be used on the skin when the patch is removed to help reduce irritation. Other ointments can help reduce irritation when the adhesive is on the skin.
• If the skin under the adhesive part of the patch has become irritated, the next time a patch is put on, try covering an area around the eye that is larger than the patch with gauze attached to the face with medical tape. Then attach the patch to the gauze.
• Try trimming away some of the adhesive part of the patch, so that there is less of it to touch the skin. But make sure that the normal eye is still completely covered and that the patch will stay in place.
• Try a patch that can be attached to glasses. These patches help avoid skin irritation and can provide good coverage over the eye. The glasses frame will probably need to have a panel that blocks side vision so that the child cannot try to see around the patch.

Now that you have read this information, you are ready to help your child wear an eye patch to treat amblyopia.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to mark areas or make notes where you have questions. Your doctor may have additional suggestions on how you can help your child to wear the eye patch.

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