My son was 22 months old when we first noticed a problem with his eyes. Whenever he focused on a toy or spoon close to his face, he crossed his eyes. His pediatrician examined him, mentioned the words “glasses” and “eye patch,” and referred us to a specialist. A few months later, our new pediatric eye doctor confirmed that my son was extremely farsighted and had strabismus.
Strabismus affects approximately 2% of American children (www.preventblindness.org/children/strabismusFAQ.html ). Children with strabismus cannot focus both eyes in unison, and may turn one or both eyes up, down, in (crossed eyes), or out (wall-eye). If strabismus is not treated in early childhood, amblyopia–loss of vision–can occur. When the eyes are misaligned, or when one eye focuses better than the other, the brain favors the images it receives from the stronger eye and ignores the images coming in from the weak eye, potentially leading to vision loss in the “lazy” eye. The most common treatments for strabismus and amblyopia are: prescription glasses, eye patches, medicated eye drops, eye exercises, and eye muscle surgery.
My 2-year-old son had to start wearing glasses (bifocals!) and an eye patch. His prescribed patch time was 8 hours a day, 5 days a week. With the patch covering his stronger right eye, he would be forced to rely on his weaker left eye, thus improving the vision in that eye. Now, my son was a very easygoing, sweet-tempered toddler, but convincing him to keep a patch stuck over his “good” eye for 8 hours out of every day was still a challenge.
He cried and took off the patch. I cried and put the patch back on. He screamed, “No!” I screamed, “You don’t wanna go blind in one eye, do ya?!” I tried punishing him for refusing to wear the patch; he didn’t care (in his mind, wearing the eye patch was a punishment). That eye patch was punishing me, too! Why did I have to be the “mean one,” forcing my baby to do something that I myself wouldn’t tolerate?! (Yes, I tried wearing the eye patch to show my son that it wasn’t a big deal. Guess what? It is a big deal!)
Allowing my son to get away with not wearing his eye patch was not the loving thing to do. I realized, after a horrendous week of yelling and crying (I cried a lot more than my son did) and non-stop power struggles, that I needed a calm, loving, patient approach. I didn’t want my son’s vision to deteriorate. I had to change my attitude toward the eye patch, and pray that my son would follow my lead. So my mantra became, “I love you, and that is why I’m going to do everything in my power to make sure you wear this eye patch!”
The eye patch stopped punishing us when I started viewing it as a loving, necessary treatment for my son. With a cheerful attitude, and unfailing commitment, I made patch time work. You can, too!
Here are some tips to make patch time easier on you and your child:
Be persistent. Be persistent. Be persistent. Think of an incentive your child won’t be able to resist. It takes about 10 minutes for your child’s brain to adjust and begin using the weaker eye after the eye patch is in place (www.preventblindness.org/children/compliancetips.html). Make those 10 minutes of adjustment time extra-special!
In those early days of patching, my son ripped off the eye patch after a few seconds. Instead of reacting angrily, I said, “Not done yet, Goofy! After we put your patch back on, you can jump on the bed!” He was not normally allowed to jump on the bed, but I made an exception during patch time. Before he could get annoyed with the patch, I held his hands and bounced him as high as he wanted. Soon he was smiling and laughing, and not thinking about the eye patch. Sometimes we played cars, colored, put together puzzles, or read books–anything that kept my son engaged and busy. I always followed any mention of the dreaded “eye patch” with fun, irresistible ideas; for example: “As soon as your patch is on, we can go look for ants outside!” “You’d better put your patch back on so we can make worms out of Play-Doh!” “Uh-oh! Where’d your patch go? Let’s get it back on right now so we can read Hop on Pop!” This approach worked wonders for us.
Decorating your child’s plain, disposable eye patch with crayons, markers, and stickers is a great way to make the patch less threatening. The Nexcare-brand “opticludes,” I discovered, are especially easy to decorate with pen or crayons. You can draw your child’s favorite cartoon character on his eye patch (on the side not touching the eye, of course), or let your child decorate her own patch. Then she can wear her artwork during patch time.
My son and I used to begin every day with “eye patch art.” If you’re not artistic, but like the idea of bold, colorful, decorated, disposable eye patches, check out the “Fun Pack” made by Ortopad (www.ortopadusa.com).
Consider which time of day your child is most receptive to new experiences and most likely to listen to you. Perhaps you’re blessed with an angelic child who always obeys, and never throws temper tantrums (why are you reading this article? Go tell your kid to put his patch on, and be done with it!). We parents of normal children all know that there are certain times of day that are “good behavior” times for our kids. Try to schedule patch time during those “good behavior” times.
My 2-year-old son was always more receptive to the eye patch first thing in the morning. I used to catch him off-guard when he was groggy (but happy) and ready for Cheerios with an easygoing, “Good morning! Let’s put your patch on and go get some yummy cereal!”
I’ve heard of parents sticking the eye patch on their child in the morning, while the child is still asleep. In theory, these kids wake up with the patch on and aren’t bothered by it. I imagine that this may work with very young children, but I don’t know any older kids who wouldn’t object to being “tricked” into wearing their eye patch.
Older children who may not be as enticed by flashy, decorated eye patches will probably wear their patch without complaint while watching a favorite TV show or movie, or while playing a video game. If you already limit TV and video game time, this is an easy way to encourage older kids to wear their eye patch: no eye patch equals no TV or video games, simple as that. A basic explanation of how the eye patch helps your child–how it makes “both eyes strong” and prevents permanent vision loss–may be all the encouragement your older child needs.
My son, who is now six and down to just one hour of patching every day, has no trouble wearing his patch as long as he knows the exact time he can take it off. Consider using a timer or a clock that your child is able to read to keep track of patch time. “This will give your child some well-defined limits and can also help avoid making you the ‘bad guy’ for making sure the patch stays on for the required time,” notes Robin Parks, M.S. (www.webmd.com/eye-health/how-to-help-your-child-wear-an-eye-patch-to-treat-amblyopia#rt1165 ).
Depending on how long your child’s prescribed patch time is, you may want to break up patch time into two separate periods. You might start patch time first thing in the morning, remove the patch before you send your child in to preschool, and resume patch time after school, for example.
If the eye patch itself is uncomfortable, experiment with different brands until you find the one that is least irritating. My son has used Coverlet, Ortopad, and Nexcare patches. His favorite is Nexcare because it adheres well, yet peels away easily. I like Nexcare eye patches because I can find them at Wal-Mart, where they cost less. Younger children might prefer a “junior” or “medium” size eye patch, or you can trim down the adult-sized patches. If your child has sensitive skin, you may want to try hypoallergenic patches or skin ointment under the adhesive part of the patch. Robin Parks, M.S., also suggests poking holes in the outer adhesive section of the patch so that less of it comes in contact with your child’s skin, or attaching the patch to gauze and securing it to the skin with medical tape (www.webmd.com/eye-health/how-to-help-your-child-wear-an-eye-patch-to-treat-amblyopia#rt1165 ). It’s a good idea to vary the exact placement of the adhesive eye patch, so that the patch is not always touching the same spots on the skin.
Washable, reusable cloth eye patches are another option. (Please check with your child’s eye doctor before switching to a different kind of eye patch; your doctor may prefer a certain kind of patch to treat your child’s particular condition.) There are many brands of cloth eye patches available online, most in the $12-20 range. The cloth patches cost more upfront than the disposable, stick-on patches, but, since they’re reusable, they are far more economical in the long run. You can find cloth patches in just about every design and color imaginable, with lots of customizable options. Some sites to check out are: www.framehuggers.com , www.perfecteyepatch.com , and www.eyepatchheaven.com .
Do you know any other kids who also wear an eye patch? Consider getting the “eye patch buddies” together for patch time play-dates. Patch time is more fun when shared with a friend. Eye patch-wearing teddy bears and dolls may also join your young children during patch time. The more, the merrier!
Patch time is easiest in a familiar, supportive environment. You don’t have to hide at home during patch time, but be prepared to deal with the inevitable curious stares and questions you will receive from other people when you go out. The most common remark I hear while running errands with my son during patch time is, “What happened to his eye?” Most well-meaning people assume that the eye patch is covering up an injury. Instead of launching into a detailed explanation of strabismus and amblyopia, I try to keep my responses simple and reassuring: “He’s fine! He’s doing a great job wearing his patch, just like his eye doctor wants him to. The patch is helping his weaker eye.” If you have to send your child to school or daycare during patch time, make sure his/her teachers and classmates know how important it is that the patch stays on.
When possible, let your child make the decisions surrounding patch time. Going without the eye patch is never an option, but where you go, who you see, and what you do during patch time may all be negotiable. Your child will appreciate being put in charge of these decisions: What design would you like on your eye patch today? Would you like to play Mario Kart with your cousins during patch time? Do you want to stay home or go play at the park? Is there a special book you’d like to read or a special snack we can make together after we put your eye patch on?
I asked my son what advice he had for parents who are struggling to make patch time easier for their children. He said, “They should play with their kids a lot during patch time. That makes it a lot better.” Reluctant eye patch-wearers should check out the “additional resources” listed below–perhaps a 5-year-old ballerina or a group of eye patch-wearing puppets will inspire your child to keep that eye patch on as prescribed! Patch time may not be party time, but with a little creativity and tons of love, we can make patch time “a lot better.” And, someday, perhaps our kids will thank us for helping them to see better, too.
Additional resources:
The Patch, by Justina Chen Headley (available at www.amazon.com ) is a children’s book about a 5-year-old aspiring ballerina who discovers she has amblyopia and needs to start wearing an eye patch.
A DVD by Bjort and Company (available at www.bjortandcompany.com/products.html ) called The Eye Patch Kids features eye patch-wearing puppets who encourage children to keep their eye patches on.
Or your child can join Prevent Blindness America’s “Eye Patch Club” (www.preventblindness.org/children/EyePatchClub.html ) and receive newsletters, a calendar with stickers to mark off days of successful patching, a pen pal form to communicate with other patch-wearing kids, and special “members only” online content. Prevent Blindness America also hosts an amblyopia discussion forum (www.preventblindness.org/cgi-local/discus/discus.cgi?pg=topics ) for parents of children with vision problems. If you need more advice or want to share your experiences with other parents, this forum is a great site to visit.
Works Cited
Amblyopia (Lazy Eye).” Prevent Blindness America. 2005. 22 Aug. 2008. www.preventblindness.org/children/amblyopiaFAQ.html.
“Amblyopia – Tips for Patch Compliance.” Prevent Blindness America. 2005. 22 Aug. 2008. www.preventblindness.org/children/compliancetips.html.
Parks, Robin. “Amblyopia – Topic Overview.” WebMD. 17 Jul. 2007. 22 Aug. 2008. www.webmd.com/eye-health/tc/amblyopia-topic-overview.
Parks, Robin. “How to Help Your Child Wear an Eye Patch to Treat Amblyopia.” WebMD. 17 July 2007. 22 Aug. 2008. www.webmd.com/eye-health/how-to-help-your-child-wear-an-eye-patch-to-treat-amblyopia.
Poore, Ralph. “Strabismus – Topic Overview.” WebMD. 16 Apr. 2007. 22 Aug. 2008. http://children.webmd.com/tc/strabismus-topic-overview.
“Strabismus.” Prevent Blindness America. 2005. 22 Aug. 2008. www.preventblindness.org/children/strabismusFAQ.html.
