The Treatment of “Lazy Eye” by Occlusion Therapy (Patching)

  • Reference Number: HEY-976/2018
  • Departments: Ophthalmology Department

Introduction

This leaflet has been produced to give you general information about your child’s treatment.  Most of your questions should be3 answered by this leaflet. It is not meant to replace the discussion between you and your child’s orthoptist, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the heath care team caring for your child.

What is a Lazy eye?

A lazy eye is an eye with poor vision. The eye itself is healthy, but something has happened to cause the vision to stop developing properly, or even to deteriorate.

Babies are not born with good vision.  During the early years of life a baby learns to use his/her eyes and by the age of 6 months he/she can see quite well. The ability to see well continues to develop during childhood and by the age of 8 the development of vision is complete.

The commonest causes of lazy eye are:

  • Squint
  • A focusing error more in one eye than the other

Why does my child need to wear a patch?

If the lazy eye has a focusing error this must be corrected with glasses first. Wearing the glasses as instructed will sometimes be enough to correct the vision in the lazy eye. However, if the vision remains reduced or if no glasses are needed, then occlusion therapy (patching) may be carried out to improve the vision in the lazy eye.

The child wears a patch over the good eye to encourage the vision in the weaker eye to improve.

It is important to realise that if a child has a squint, the purpose of the patch is to improve the vision in the eye and will not improve the squint.

Can there be any complications or risks?

 It is very important that the patching is carried out exactly as instructed. There are dangers in carrying out too much patching but equally if not enough patching is done soon enough, the vision may not improve to a satisfactory standard because valuable ‘development time’ may be lost.

What WILL happen?

 The orthoptist will advise how long and how often a child should wear his/her patch and what sort of patch it should be.

The patch is applied to the child’s face, with glasses on top if worn.

Some children need to wear their patch for most waking hours, while others may require a period of part-time wear. The treatment may take several months.

The decision about the type of patch and the length of time it should be worn will depend on the age of the child and their level of vision. The younger the child, the more quickly he/she will respond to patching.  After visual development is complete at age 8 years, patching treatments becomes ineffective.

How can I help my child with the treatment?

When wearing a patch a child will need lots of help and encouragement as he/she is not used to coping with poor vision and may well resent the patch. However, as the vision improves, the patch becomes less of an issue. Getting over the initial difficulty is of great importance if the patching is to be effective.

Your child should be encouraged to make the lazy eye work hard. “Hard work” for eyes includes colouring, puzzle books, reading/story books, computer games – in fact anything detailed a child wants to see.

How often do i need to attend with my child?

A child who is wearing a patch must have the vision checked regularly to measure progress and to decide whether the treatment plan needs to be altered.

The orthoptist will advise how soon the child should attend the clinic again for the vision to be checked. It is important that you do not miss your appointment. If you find you are unable to attend, please let us know on the number below.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.