Patching Instructions - Eye Care San Luis Obispo



Patching Instructions - Eye Care San Luis Obispo
689 Tank Farm Road, Suite 100
San Luis Obispo, CA 93401
(805) 781-3937 • fax (805) 781-9013
234 Heather Court, Suite 102
Templeton, CA 93465
(805) 434-5970 • fax (805) 434-5973
Patching Instructions
our Eye MD has recommended that you patch your
child’s eye for the treatment of amblyopia or to improve the control of a drifting eye. Please understand
that although your doctor can recommend patching, only a
parent and child working together can carry out the treatment. This treatment is very important. Failure to complete
patching therapy for amblyopia can result in poor vision that
may not be treatable in the future. Amblyopia is only treatable
while a child is young. The older the child the less treatable
amblyopia becomes. Once a child is ten or twelve years of age,
amblyopia is no longer treatable and the resulting vision loss
is permanent. When patching is used to control a drifting eye,
failure to patch may lead to further loss of control of eye position, the need for surgery or the development of amblyopia.
We understand that patching is difficult, time-consuming and
stressful for both the parent and child. However, the rewards
are great. We hope these tips will make patching easier and
more successful.
When to start and stop patching
We recommend that you patch your child’s eye at the same
time every day. It is most critical that the patch be removed at
the same time every day. Young children cannot tell time, so
they do not understand how long three hours or five hours
lasts. They do understand that the patch will come off at
lunchtime, dinnertime, or bedtime. If you remove the patch
at a different time every day, the child usually begins to think
that perhaps their behavior is the reason their patch is coming
off. They will often experiment with a whole range of unpleasant behavior in an effort to get you to remove the patch.
To avoid this, we recommend that you begin patching a
short time before you plan to remove the patch and work
backwards, gradually increasing the time your child remains
patched. In very young children and infants this gradual increase is not necessary and you can immediately start patching the full prescribed amount of time.
Fight boredom; consider bribery
teacher’s help. Be firm, loving and consistent. Children can
tell how committed you are, so stick with it. Let your child
know that patching is non-negotiable.
Arm restraints
With very young children and toddlers you may initially
need to use “arm restraints” to prevent removal of the patch.
These can easily be made by using part of a paper towel roll
cut lengthwise and put around the arm so the elbow cannot
bend. Tape the paper towel roll closed, then cover it with long
sleeves. If a child is large and very strong, a rolled up magazine can work the same way. Our office also sells professionally made arm restraints. Happily, arm restraints are usually
only necessary for a couple of days.
Working with patches
Both Coverlet™ and Opticlud™ brands of patches are available in most large drug stores. Ortopad™ patches are usually
less expensive and are only available by phone (1-800-4866169) or on the internet (
Some children have sensitive skin and may react to the patch.
If so, try a different brand. To reduce irritation, try removing patches in the shower or at bath time. Also try putting a
little lotion or Vaseline™ on the skin after removing the patch,
but don’t get any in the eyes! You can also trim the patch to
reduce the amount of adhesive in contact with the skin, or
rotate the patch in different directions each day. Except in
unusual circumstances, we do not recommend that you use
the black fabric or plastic “pirate patches” as they are too easy
to peek around or remove.
There are alternatives to patching but many of them are less
effective. Therefore it is important to make every effort to
make patching successful. Please call us if you need advice,
encouragement or moral support. We are here to help! N
Occlusion Schedule
Bored children are more likely to remove their patch, so try to
keep them busy and occupied while patching. New research
shows that detailed near work while patching may increase
and hasten the effectiveness of patching. Examples of detailed near work include working mazes, coloring, reading,
doing homework, I-Spy books, and computer or hand-held
video games such as Nintendo. With older children, try
rewards and star charts. Many children patch very well at
preschool. Try taking the patches to sharing and enlist the
Name:_ _________________________________________________
❑ Right eye_____________________________________________
❑ Left eye:______________________________________________
Copyright © 2006 Rena A. Stathacopoulos, MD

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