Amblyopia (lazy eye) can be a result of an unequal refractive error, strabismus (misaligned eyes), crossed eyes or other abnormalities. Patching is a treatment for amblyopia where the strong eye is patched to encourage the development of better vision in the weak eye.
Patching should begin as early as possible. This can be difficult, depending on the child's age. If the child attends school, you will need to enlist the help of the child's teacher. Explain the need for treatment and the patching schedule that your doctor recommends to your child's teacher and have the teacher encourage the child to continue his/her normal routine. The teacher can also help explain the child's situation to classmates.
The patch should be comfortable and should remain in place. The child should NOT be able to see around the edges. You may purchase patches at most drug stores. They come in "regular" and "junior" sizes. You can also use a gauze pad held in place by hypoallergenic tape. Black eye patches with elastic are not recommended because they don't stay in place as well and may allow the child to see around the sides. If the skin becomes irritated, leave the patch off at night and try a different type of patch or tape.
Length of treatment varies depending upon the individual. Generally, the younger the child when patching begins, the sooner the treatment can end. In young children, vision changes may occur quickly. Occasionally, vision in the good eye may be decreased when the patch is removed, but it usually returns to normal as soon as that eye is used again. Sometimes patching may continue after the vision stabilizes to ensure the child has the best possible chance to develop normal vision. Once the vision in the amblyopic eye has improved, there is a slight chance that it could worsen again so it is important to continue close monitoring throughout childhood.
It is also possible that vision may not improve with treatment. If this is the case, your doctor may recommend that treatment be stopped.