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Ophthalmology

For Parents of Children Wearing a Patch on their ‘Lazy Eye’

Patient Information Leaflet

Introduction

Patching is used to treat a condition called amblyopia, which is reduced vision in an otherwise healthy eye.

An eye with reduced vision is often called a lazy eye.

Following an examination, it has been found necessary to recommend patching your child’s lazy eye to give that eye the best chance of visual improvement. This treatment is called inverse occlusion.

Some questions and answers

  1. Q) Why does my child need to wear the patch on their lazy eye?
  2. A) Your child has been chosen to have this treatment because the vision in their lazy eye is very weak and the eye has eccentric fixation.
  3. Q) What is eccentric fixation?
  4. A) This is a condition that occurs when the lazy eye fixates / looks with an area of the retina away from the normal central area. The area that is being used only allows for poor vision.
  5. Q) Can eccentric fixation be treated?
  6. A) Patching of the lazy eye disrupts the eccentric fixation so it becomes unfixed, increasing the chance of improving the vision in the lazy eye with conventional patching.
  7. Q) How long will the treatment take?
  8. A) The patch will need to be worn for a minimum of four weeks, but may need to be worn for between eight to 12 weeks in total on the lazy eye. The orthoptist will check at each visit to see if the eccentric fixation has been disrupted, and will advise you when this part of the treatment has finished.
  9. Q) What will happen when the patching of the lazy eye finishes?
  10. A) The patch will then need to be swapped to the good eye to treat the remaining amblyopia or reduced vision in the lazy eye, and this will usually start with six to eight hours patching daily, reducing as the vision improves.
  11. Q) Can patching of the lazy eye be done at any age?
  12. A) It is most effective in young children whose visual system is still developing. This time is known as the critical period and is when the lazy eye responds most readily to patching. Therefore, it is vital to make every effort to encourage your child to wear the patch exactly as the orthoptist asks.

Pointers to successful treatment

Do ensure that the patch is worn for the full length of time recommended. Using the patch for less time than the orthoptist asks will reduce the success of the treatment.

Do continue to wear your glasses as recommended during the patching hours. Patching does not mean wearing of glasses should be abandoned. If a sticky patch is worn, then the glasses are worn as normal. If a fabric patch is worn, then please follow the packet instructions on how this is worn over the lens of the glasses.

Do encourage and be firm with your child during the treatment. Most children will tolerate the patching of their lazy eye well, but they can get to a stage where they don’t want to wear it. It is important that you continue the treatment.

Do keep your hospital appointments so that treatment can be carefully monitored. Failing to keep appointments can delay treatment and can mean the difference between success and failure.

Possible problems

Please be aware that because your child is wearing a patch, they will have a reduced area of vision. Therefore be extra vigilant with your child near roads and when playing and going up and down stairs.

Sometimes children will develop an allergic skin reaction to the patch. Should this occur, please contact the Orthoptic Department for an alternative type of patch.

Note: the information in this booklet is provided for information only. The information found is not a substitute for professional medical advice or care by a qualified doctor or other health care professional. Always check with your orthoptist if you have any concerns about your condition or treatment. This is only indicative and general information for the procedure. Individual experiences may vary and all the points may not apply to all patients at all times. Please discuss your individual circumstances with your orthoptist.

The Orthoptic Department at Russells Hall Hospital: 01384 456111 ext. 3636 (8.30am to 4.30pm, Monday to Friday)

Eye emergency, out of hours

In case of an eye emergency after the closing hours of the Eye Clinic (including weekends and bank holidays), please contact the eye doctor on call by ringing the switchboard at:

Birmingham and Midland Eye Centre on 0121 507 4440

The doctor on call is usually based at the Eye Centre, City Hospital, Dudley Road, Birmingham. They may need to call you back, and if necessary, they will arrange for you to visit them.

We are always happy to answer any questions regarding your child’s treatment. If after reading this leaflet you still have concerns or questions, please call the department on 01384 456111 ext. 3636

Author
Rachael Templeton
Specialist Orthoptist

For further information visit: www.orthoptics.org.uk/patients-and-public/

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Parents of children wearing a patch CS/RT/SM/ST/09 2024/v4 – review 06.2027 DGH/PIL/02036