What is amblyopia?
Amblyopia or lazy eye is the reduction in vision in an eye that has not been used during childhood, resulting in reduction of vision in that eye.
It occurs when one eye experiences a blurred view and the other a normal view but the brain only processes the normal view (see image).
The reduction in vision cannot usually be corrected with glasses, contact lenses or surgery. Patching or occlusion is a common and important treatment method for amblyopia.
The pathways that connect the eyes and brain develop throughout childhood until about the age of 10 years at which stage the development slows down and vision can no longer be improved.
Occlusion treatment must therefore be performed as early as possible within the first 10 years of life for it to be successful.
With consistent patching and doctor’s review, children’s vision generally improves.
Patching involves physically covering (occluding) the stronger eye, which is the eye that your child prefers to see out of. This forces the weaker (amblyopic) eye to work harder, thereby allowing development and strengthening the vision in that eye.
The amount of occlusion is dependent on how severe the amblyopia is and will be advised by the consulting Ophthalmologist or Orthoptist. For achieving the best results in amblyopia therapy, totally covering the stronger eye is often recommended. For this reason, eye patches that stick to the skin around the eye are most effective. Strap-on ‘pirate’s patches’ and patches worn over glasses are less effective and only occasionally recommended.
It is common that children with amblyopia will refuse to wear the patch and remove it when left unsupervised. Therefore patching should start during a time when you can devote all of your attention to your child (e.g. weekend). Typically, the first few days are the most difficult.
To obtain the full benefit, ensure that your child actively uses the vision in the ‘weaker eye’ when the ‘stronger eye’ is being patched. You could do so by keeping them engaged – playing board games, playing with the iPad, reading, painting and drawing. This helps them form a connection between the brain and the eye.
The following Apps, for download to an iPad or tablet, are good tools to assist your child:
- Playschool Art Maker
You are able to split the hours of patching throughout the day. So if you are asked to patch for 4 hours, you may patch for 2 hours in the morning and 2 hours at night.
If your child removes the patch, quickly replace it. Continuous encouragement and use of incentives may be needed to ensure your child wears the patch.
Types of patches:
Directly over the eye:
- Opticlude (Nexcare) Eye Patches – purchased from any chemist in sizes junior and adult.
- Ortopad Patches – purchased via the following websites:
- www.myipatches.com – sizes junior and regular
- www.ortopadusa.com – sizes small, medium and large.
- Coverlet Eye Occlusor Pads – can be ordered and purchased via www.medshopexpress.com
- Krafty Patches – can be ordered and purchased via the website www.kidseyepatches.com.au in regular and medium size.
Patches for over glasses:
- Ezy Patch – purchased from Woods Pharmacy (retail chemist) at the Royal Children’s Hospital (1st Floor Front Entrance, Flemington Rd Parkville) or 03 9345 6500 for phone orders.
- Blinkers Eye Patches – purchased via the website www.blinkerseyepatches.com
- Patchmate Eye Patches – can be purchased via the website www.patchmate.com.au
For more information regarding treatment options, please speak with your Ophthalmologist or Orthoptist on 03 9929 8448.