Clinical Hub,Patient Education,Health and Nutrition Facts For You,Ophthalmology

Patching Therapy for Amblyopia (4956)

Patching Therapy for Amblyopia (4956) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Ophthalmology


Patching Therapy for Amblyopia

The goal of patching for amblyopia is to improve the vision in the poorer seeing eye and obtain
the best possible vision in each eye. Patching of the better seeing eye will help to stimulate the
brain to improve connections with the poorer seeing eye.

When should the patch be worn?
The patch should not be left on during sleeping hours at night. It may be handy to leave the patch
on during naps in the daytime.

Patching has been recommended on the following schedule.

What types of patches can be used?
There are several patches that can be purchased. Ask about the patches in the clinic before you
leave. Be aware that some of the adhesives are better than others for your child’s skin. Look for
patches in different sizes. If your child wears glasses, some styles and sizes of patches will fit
better under the frames than others.

When putting the patch on, firmly press the adhesive part to your child's skin to ensure a good
seal. If a child peeks around or through a spot where the patch doesn't stick to the skin, the
patching will not work as well. This is why we do not want you to use the black cloth tie-on or
“pirate” type of patch. They don't fit the face well and allow the child to peek. They also move
around under glasses. Some parents construct homemade patches out of colored, printed paper
or cloth. If you choose to try this, make sure the patch fits around the eye snugly and does not
allow peeking.

Will my child have any skin irritation with the patch?
Sometimes children will have red and sore skin where the patch is worn. The best way to avoid
this is to use care when you remove the patch. Do not pull it off quickly. Sometimes, your child
may prefer to rip it off. This often can pull off a small layer of skin causing the spot to get raw
and sore in a few days. Sometimes children have skin sensitivities to the adhesive in the patch.

If you suspect this, try another brand of patch or make a patch and use non-allergic tape to put it
on. Also, a large patch can be cut to a smaller size to fit a small child's face. There are ointments
or other treatments that can be used if this becomes a problem for your child. Call the clinic and
discuss this with one of the staff.

What problems can I expect with getting my child to wear the patch?
At first, it is common for a child to resist wearing the patch. Your child may not like to have the
best-seeing eye covered up. A child often cannot understand or accept the reason for wearing the
patch. The child realizes that vision is better without the patch on. This can be very frustrating
for parents. It can be tempting to give in to the child. But, each time the patch is taken off, the
goal of improved vision in the “lazy” eye is delayed.

It is important that you realize that you are not alone in carrying out this treatment. Talk over
your problems and successes when you come into clinic or call and talk with one of the staff
before your next visit. The staff can offer ideas to help you with the problems you are facing
with your child. In time, most families find that the patching routine becomes easier and does
not interfere with daily life.

What suggestions can you provide to help with this adjustment?
Depending on the age and personality of your child, there are some strategies for success you
might wish to try. A reward system works well for some children; some like a sticker for each
day the patch is worn well. Some older children like to see their patching schedule on a calendar
and want a star placed on each day the patch is worn well. Others like to color or draw on the
patch before putting it on.

If the child is in school, his teacher needs to know about the value of patching, as well as the
temporary limits of vision.

It is best for parents to be firm, but kind as they enforce patching. Often children will “test” their
parents by taking off their patches again and again. Early in patching therapy, a child needs to
learn that he or she will not succeed in taking off and going without the patch. This may mean
taking one full day to stay with a toddler to be firm about wearing the patch and to replace the
patch right away if it is removed. Spending extra time reading or playing with your child will
show him that he can see and play with the patch on. When parents are consistent and firm about
patching, a child will most often comply by wearing the patch.

If you have any questions please call:
UWHC Pediatric Eye Clinic: (608) 263-6414, 8:00 a.m. – 4:30 p.m., Monday – Friday.
Nights and weekends, this number will give you the hospital paging operator. Ask for the Eye
Resident on Call and leave your name and phone number with area code. The doctor will call
you back.
If you live out of the area, please call 1-800-323-8942.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911.Copyright 1/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4956