The purpose of this page is to provide helpful hints to parents about patching their child's eye for the treatment of amblyopia, commonly known as “lazy eye.” And, there is no better source for information about patching a child's eye than parents.
As a consequence, we are requesting those parents who have experience with patching therapy to share their wisdom and experience with everyone. This web page will be updated as experienced parents share hints, techniques, types of bribery, behavioral methods and everything else one can think of in order to get the child to wear his or her patch.
Vaseline for Patch Irritation
"My daughter has been patching for around 6 months and has made lot of progress. One issue we have run into is how well the patches adhere and the irritation that causes to her skin. The stickiness is great for keeping the patch on my active girl, but not so great for her sensitive skin!
"For months I have used the recommended Milk of Magnesia around her eye and that makes removing the patch easy and prevents her skin from tearing.
"Lately though, she has been having a reaction to the Milk of Magnesia right under her eye. I don't know if it is because the skin is thinner and more sensitive there? I actually had to give her a couple days off from patching to let her skin heal. Unfortunately the irritation came back immediately when we started patching again.
"I decided to put a very thin layer of Vaseline directly under her eye and the Milk of Magnesia around it to see if that would prevent the irritation. So far it has worked great and we are back to our normal patching routine and schedule.
"She has done very well with patching and one thing that makes it easier and more enjoyable for her is the cute, girly patches you provide. She loves picking one out each morning and coordinating them with her outfits. Thank you OAR for the help and support and for making this journey easier!"
"In the fall of 2007, Aiden was 4 years old and attending Central College Preschool. His vision was screened and a notice was sent home that he had failed. We received a phone call from Prevent Blindness Ohio, who coordinated the vision screening with the preschool. Prevent Blindness Ohio really cared and was concerned for Aiden's vision. I have never known anything like that before. It meant so much back then, and continues today.
"At the time in 2007, my husband and I had NO idea that Aiden had any difficulty with his vision. Initially, I believed that he must have failed the screening because he was a 4 year old boy, with little to no attention span. However, the eye exam done by his ophthalmologist confirmed the preschool vision screening's results. I will never forget sitting there in that office...stunned, with that parental gut wrenching feeling, as I watched him miss every answer on the tests in his right eye...after he performed them perfectly out of his left eye. How could we have missed this? He was seeing 20/20 out of his left eye, but 20/100 out of his right...and all this time we had no idea!
"The first step was fitting him for glasses. After a couple months in them, with no improvement, we moved on to patching. We decided that patching during preschool hours would be optimal, since he was so engaged and it would really force his eye to work. We also took the approach that if life hands you lemons, then you make lemonade. I started drawing on his patches every day, or making some artistic attempt to 'jazz' them up. I tried to coordinate his patch with whatever they were learning about in preschool or the holiday being celebrated. The best was Halloween! And I loved that whenever Aiden drew a picture of himself, he included the patch! He accepted it as if it was just another part of him.
"He's never let it bother him, and if kids would ask 'what happened to your eye', then he would matter of factly state that he had a weak eye and he was making it stronger by wearing the patch (and he'd hold up both arms in a flex position). I became a BIG advocate for vision screening and told anyone who would listen about Aiden's story. It was my duty to educate, as I had no idea myself until I was handed his diagnosis.
"Aiden is now 8 and still wears a patch daily. He is so accustomed to wearing the patch that he puts it on by himself, and wears it for 4 hours a day. He knows the minute he puts it on...and then the minute it can come off (it's not just 8pm...it's 8:07!). And when his eye itches, he'll lift the patch, fix the itch, and then put the patch right back down. Meanwhile, I stand in amazement that this 8 year old has the self-discipline to do that!
"Aiden has now progressed to 20/30 with his glasses in that right eye. It's been a struggle, as it seemed that eye was pretty stubborn in wanting to correct, however with the patching, the constant love and support, and early findings from his preschool vision screening, we're now a success story. And I'm honored to be able to share our story with you and show how Prevent Blindness Ohio has touched our life and saved our son's sight."
"I am 19 years old and have a lazy eye, and didn't follow through with my treatment because of all the sports I was in. I am now trying to become a firefighter, and realize that you need 20/20. I am wearing my patch now, but wish I did it when i was younger. Parents if your child has a lazy eye, take care of it now! Your children will be upset later."
Patching During Sleep
Like most parents of younger children, it can be a real ordeal to put a patch on your child's better eye to treat his or her lazy eye. So try this: place the patch on his/her face BEFORE waking him or her up! Once the patch is on it may be a lot easier to keep it on for a certain amount of time. This strategy may work and help you avoid the big morning fight to put the patch on his or her eye. But remember - patching only works when the child is awake and has the lazy eye open. Patching therapy doesn't work if the child is asleep.
The "Ks" have an energetic one year old who was diagnosed with amblyopia during the first months of life. At about 6 months of age he had 20/100 vision in his good left eye, normal for his age, and 20/150 in his right amblyopic eye, the eye that turns inward a bit when both eyes are open. In fact, it was the slightly deviated eye that the parents worried about and lead to his visit to the pediatric eye doctor. After six months of patching, he had 20/80 visual acuity in each eye, normal for his age, because of the parents' perseverance in occluding his stronger, left eye. His amblyopia was cured. I asked the Ks about their success in occlusion therapy and here is what they had to say:
They patched their son for 2 hours per day in the morning after he was alert, fed and changed. The mother would place the patch on his left eye as directed by their eye doctor, and engage in activities with him and their older child. At first, he would try to remove the patch and Mom would simply distract him with toys and other activities. Soon, he would forget he had the patch on and would play with his toys and sibling. Mom would continue to play with both of the children for the two hours. Mom indicated that she could not simply place the patch on his better eye and let them play alone for any length of time since he would soon remove the patch. The trick was to keep him occupied and engaged during the patching period. In addition, it was important that Theo was not tired or that it was not too late in the day.
Dad also played an important in his therapy. Dad said that he thought that visual activities, such as going to the food store, helped. At the grocery store, he was stimulated by moving through the isles of food and people. Dad wheeled him around the store in the grocery cart stimulating his amblyopic eye with the patch on his stronger eye. He loves the grocery store because of all the visual stimulation.
His success story is due, in part, to the fact that his amblyopia was detected early in life when patching is the most effective and when his vision in the amblyopic eye wasn't too bad. It also helped that he only had to wear the patch a few hours per day. Other children, with worse amblyopia, may have to be patched much longer. But nothing can take the place of dedicated parents who know the importance of perseverance - you do what you have to do and get the job done. He will be thankful when he is older that his parents persevered.
The "Z's" daughter was diagnosed with amblyopia at 4 months of age. At 5 months of age her visual acuity was 20/150 in the amblyopic right eye and 20/80 in her normal left eye. She was prescribed glasses and she learned quickly to pull them off "every five seconds" said the mother. Mom said that she persevered and entertained her until she adjusted to the glasses. Her older 3 year old sister also helped and would "tell on" her sister whenever she removed her glasses; "get those glasses on" she would say and was vigilant about her sister wearing her glasses. Than came the patching.
At first, patching was easy said the mother because her daughter "couldn't even figure-out how to remove the patch". But that changed quickly. Again, Mom entertained her when she was wearing the patch and her 3 year old sister also helped monitor to make sure that she kept the patch on the required time.
Her mother also recruited the help of their baby sitter, grandmother as well as the day care personnel to ensure that she wore her patch the required time. The mother reported that she "wanted her to see" so she persevered. The mother also said that she had the personal responsibility to ensure that she would not grow up with one good eye.
The Z's perseverance paid off. In December 2007 she had a follow-up and she now has 20/80 visual acuity in each eye, normal for her age of 17 months. The mother was vigilant about maintaining her eye doctor appointments and will in the future.
"I have a 5 year old girl that has patched on and off since she was about 18mos. We sometimes use a marker and draw a colorful eye with long eyelashes on her patch, we have also put on a favorite sticker, used a chart to mark the days she has worn her patch and given a reward at the end of a week, pretended we were pirates on an adventure, encouraged her with praise, hugs and kisses and informed her about why she needs to patch so that she can let other kids know that she is 'growing a stronger eye' kind of like a super hero. I also let her choose her eyeglass frames and cases and make sure to buy clip-on sunglasses so she can be 'like her friends'. Some days it seems that nothing works and we both want to cry but we keep hanging in there!"
Special Reading Time
"We offer our daughter, age 5, 'Special Reading Time' at the end of the day as a reward for her being agreeable and not complaining when we put her patch on her eye. 'Special Reading Time' occurs after we have read to her and her three-year-old brother, while her brother is going to sleep. Most of the time is spent with her reading to us, but we also read to her. She loves being allowed to have a later bedtime, and she especially loves that she gets to stay up later than her brother. She also really looks forward to the one-on-one time with a parent that is difficult to find during the day. She actually acts excited to put on her patch now most days!"
Make It Fun
"We bought Sponge Bob Square Pants band-aids and put them over his 'good eye' lens on his glasses. That made it seem fun, and the other kids in his kindergarten class thought it was cool. The trick though, is to make sure he looks through his glasses and not over them. Also, playing video games with a patch for an hour or so per day helps too."