Patching for amblyopia

Your doctor will instruct you:

Which eye to patch
How many hours per day the patch should be worn

Patching instructions

Remember to patch the ‘stronger’ eye in order to encourage the ‘weaker’ eye to work. This means that your child might dislike having the patch on as their vision will not be as good. You can distract them by giving them games to play, or doing their favourite activities. Your orthoptist can give you more tailored suggestions based on your child’s likes, lifestyle and abilities.
If you are using ready-made patches, the smaller notch on the patch is placed closer to the nose. Please make sure that this is properly stuck on the skin to prevent peeking.
Please ensure that the whole eye is covered and that your child isn’t peeking around the patch. Adhesive eye patches are recommended – fabric/pirate patches can easily be moved around while the child is moving and create gaps where they can peek through. See below for more information on where to get adhesive eye patches.
Please check that the patch is completely covering the eye every now and then, as your child might instinctively pull on the patch or move it around.
For children with glasses, make sure that they are wearing their glasses while patching. The adhesive eye patch is worn under the glasses, as placing them on top of the glasses will create gaps. If they really won’t tolerate the adhesive patches under the glasses, Eze-patch is a viable option. You can get these online.
NOTE: Placing a cover on top of the glasses is not sufficient occlusion.
For school-age children, they can wear their patch in school or at home. You will be advised on what is more suitable for your child.
Patching time only includes the time they are patched while awake.

NOTE: While the patch is on, your child’s vision will be poor and they may have difficulty judging distances. Please keep a watchful eye on your child especially when crossing the road, going down the stairs, or when running and playing around.

It is normal for your child to get frustrated while wearing the patch as we are encouraging their ‘weaker’ eye to work. Please stay close to them and provide positive reinforcement and reassurance.

What should the child do while patching?

Close-up activities are best for your child while they are patched, in order to ‘exercise’ the amblyopic eye. Your doctor or orthoptist will recommend activities you can do based on your child’s age, ability and lifestyle, however in general we recommend an activity that requires some visual concentration.

Examples of close-up activities include:

Drawing/writing/colouring
Reading
Puzzles
Doing homework
Games, or Apps on a phone/tablet

Distracting your child with close work that they enjoy can help with compliance.

As your child’s vision will initially be poor on the unpatched eye, it is recommended to start them off with activities with large print, contrasting colours, or playing games with less detailed reading, like play dough. You can then slowly increase the visual difficulty of the games, like progressively smaller print, or puzzles.

Note that watching TV for long periods with the patch on may be counterproductive, as your child might get used to audio cues, rather than exercise their vision.

How do I convince my child to patch?

For younger children, you can put the patch while they’re sleeping, so that when they wake up they may not notice that they have a patch on. Please note that patching hours only include the hours they are patched while awake.

If you have plain (skin-tone or white) patches, you can involve your child in designing their own patches with stickers and/or colourful markers.

Some patching boxes come with patching charts that your child might like. You can reward them for a job well done with a sticker on each day they successfully complete their patching hours. Additionally, you can also encourage them with prizes, such as lollies or stickers for a job well done.

For those with an iPhone, there is an interactive app called “Patching Pirate” that you can download from the App Store to help with patching. You can also go to www.eyesite.nhs.uk/EyeFive/index.php?page=home for another interactive website if your child is old enough.

Having a routine might make patching easier for you and your child. Patching at the same time every day can help you and your child get used to the routine and create a good habit.

Where do I get more patches?

Most chemists stock plain white or skin tone patches. Make sure you buy the right size for your child. Generally, Junior sizes are recommended for children until 2 years, Medium for children aged 2-4 years, and Regular for 4 years and above. A fun idea might be to let your child design these eye patches themselves with stickers or coloured markers before use.

More colourful options can be purchased online. Here are some examples of websites you can purchase them from:

Product name: Ortopad Fun Packs or Ortopad Soft for Boys/Girls

Company: OptiMed

Contact no.: 1300 657 720

Website: www.eyepatch.com.au

Product name: Eye Patches (MYI)

Company: All States Medical Supplies

Contact: 1300 520 510

Link: http://www.allstatesmedical.com.au/products/category/JCSBPYCE-eye-patches

Product name: Kids Eye Gear Adhesive Orthoptic Eye Patches

Company: Kids Eye Gear

Contact: 0414 566 894