Treatment of Amblyopia

Amblyopia means that one of the eyes is not being used and fails to develop normally. We attempt to treat amblyopia and prevent this eye from becoming "lazy". There are various modalities of therapy that are used including medicine, glasses and patching. The most important fact that the parent must understand is that the treatment of amblyopia must be done as a child. Failure to prevent this lazy eye will leave the child with a permanent defect in one eye; therefore strict adherence to the therapy must be obtained.

The most common therapy would be patching. Patching can be done in various ways. The most common way and the most useful way is a full-time patch. A full-time patch means that the patient blocks the good eye with a patch at all times, then follow-up visits will ascertain if it is doing its job.

Sometimes we use part-time and alternate patching. Occlusion therapy with a patch is the responsibility of the parent and the parent must understand that if the child pulls off the patch, they have to deal with this. Infants and young children who pull off the patch can be dissuaded from this by mittens, elbow restraints or whatever method is needed. Usually the child will adapt after a few days. Restraints can be made using tongue depressors and flannel silverware wrappers. The restraints are tied above and below the elbows, allowing free use of the hands and wrists and shoulders but preventing flexion of the elbow so that the fingers cannot grasp the occluding patch.

The patch must be a patch that adheres to the skin around the eyelids; the two most commonly used products are Elastoplast Eye Occlusors and Opticlude. The Opticlude is nonallergenic. Tincture of Benzoin applied to the skin prior to the eye patch will help solve the problems resulting from perspiration. It also forms a base on the skin that prevents skin irritation that can occur underneath the patch. Micro pore paper tape can also be used to help cover the eye. In addition, the child's glasses must be worn at all times.

Visual tasks should be given to the child while he is patched, be it part-time or full-time occlusion. These tasks will help strengthen the "lazy" eye. These tasks can include puzzles, books, coloring, etc.

The importance of this treatment cannot be overemphasized and the need of the patients" families to adhere to this regime cannot be overemphasized.