RE: Eye Patching

[Guest guest]

Does have an OT that is SIPT certified? If so, ask him/her to work on

a sensory diet to help him learn to wear the glasses over time. We had a

hard time getting Trisha to wear her glasses as well and then we got this great

OT who worked up a sensory diet for the many sensory overloads Trisha has

one being wearing anything on her head or neck or arms an now she will wear her

glasses the whole time during school and takes them off to come home. Her

eye doctor said that was fine because it is a strain for her to have to focus

her eyes for so long a period and that unless we are doing school work or

something she really needs to focus she needs her down time without the

glasses.

The same was told us by her audiologist about wearing her hearing aids. So

we focus on her wearing them at school and when she comes home she can let

her hair down. :-) She still has a hard time with wearing headphones, she

gets upset and will remove them almost instantly and even at school she has not

made a lot of progress with the headphones. She is now able to tolerate her

vibrating watch for longer periods of time. I am happy with that for now.

At least she can see and hear and have her watch remind her when it's time to

go to the bathroom which is a good improvement. :-)

What kind of sensory diet do they use at school?

Carol

Trishasmom

She isn't typical, She's Trisha!

If we always do what we've always done, we'll always get what we've always

gotten.

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[Guest guest]

It all depends, when Trisha wore her first patch it was after surgery and it

was to protect the eye and was to be on 24/7 but the second time she wore a

patch (and not for long believe me) it was to correct the eye before putting

glasses on her and she had to wear it while awake and could take it off to go

to sleep.

Carol

In a message dated 5/19/2008 9:16:10 P.M. Eastern Daylight Time,

brendamcdonnell@... writes:

These patches can be used while sleeping? For some reason I thought one had

to be awake/alert for the benefit to be realized.

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[Guest guest]

I had to wear a patch as a child - it was torture for me and I used to take

it off on the way to school and put it on on the way home - you know how

much good that did???

But now they have a really TIGHT taped one that covers the eye like a pirate

patch - very hard to remov. Bet your kid could get used to it. I used this

type withone of my patients. We put it on when he went to sleep. Then by

the timehe ralized it was there in the morning, the 2-3 hours were over.

Elie is far sighted, but after much trials and tribulations - including

buying racketball goggles, we decided that like his hearing, he probably is

better off not being too acute.

On Mon, May 19, 2008 at 4:23 PM, McDonnell

wrote:

> Can anyone share their experience with their child wearing an eye patch?

> saw the pediatric opthalmologist today- his farsightedness has

> increased and he is now a candidate for eye glasses.

> However, the doctor recognized that it will be very difficult for him to

> wear them, so she said that patching his good eye is an alternative ( 2

> hours a day). is so sensory sensitive, I can't even see him wearing

> one for 2 minutes!!

>

> Any strategies/recommendations?

>

> Thanks in advance for your wisdom!

> Best,

>

> Mom to , 4.5 years old

> DS/PDD-NOS

>

>

[Guest guest]

>

> Can anyone share their experience with their child wearing an eye

patch?

> saw the pediatric opthalmologist today- his farsightedness

has increased and he is now a candidate for eye glasses.

> However, the doctor recognized that it will be very difficult for

him to wear them, so she said that patching his good eye is an

alternative ( 2 hours a day). is so sensory sensitive, I can't

even see him wearing one for 2 minutes!!

>

> Any strategies/recommendations?

>

> Thanks in advance for your wisdom!

> Best,

>

> Mom to , 4.5 years old

> DS/PDD-NOS

>

>

[Guest guest]

>

> Can anyone share their experience with their child wearing an eye

patch?

> saw the pediatric opthalmologist today- his farsightedness

has increased and he is now a candidate for eye glasses.

> However, the doctor recognized that it will be very difficult for

him to wear them, so she said that patching his good eye is an

alternative ( 2 hours a day). is so sensory sensitive, I can't

even see him wearing one for 2 minutes!!

>

> Any strategies/recommendations?

>

> Thanks in advance for your wisdom!

> Best,

>

> Mom to , 4.5 years old

> DS/PDD-NOS

> , I do not know! It would be hard if it were , I think

I would allow him to watch his favorite movie as a treat while he

was wearing it, I cannot think of anything else. This will be a

long two hours though. Good luck! I will think about you with this.

Sarno

>

[Guest guest]

Sara,

These patches can be used while sleeping? For some reason I thought one had to

be awake/alert for the benefit to be realized. Thanks,

To: @...: pastmidvale@...: Mon, 19 May 2008

17:48:58 -0500Subject: Re: Eye Patching

I had to wear a patch as a child - it was torture for me and I used to takeit

off on the way to school and put it on on the way home - you know howmuch good

that did???But now they have a really TIGHT taped one that covers the eye like a

piratepatch - very hard to remov. Bet your kid could get used to it. I used

thistype withone of my patients. We put it on when he went to sleep. Then bythe

timehe ralized it was there in the morning, the 2-3 hours were over.Elie is far

sighted, but after much trials and tribulations - includingbuying racketball

goggles, we decided that like his hearing, he probably isbetter off not being

too acute.On Mon, May 19, 2008 at 4:23 PM, McDonnell

wrote:> Can anyone share their experience with their

child wearing an eye patch?> saw the pediatric opthalmologist today- his

farsightedness has> increased and he is now a candidate for eye glasses.>

However, the doctor recognized that it will be very difficult for him to> wear

them, so she said that patching his good eye is an alternative ( 2> hours a

day). is so sensory sensitive, I can't even see him wearing> one for 2

minutes!!>> Any strategies/recommendations?>> Thanks in advance for your

wisdom!> Best,> > Mom to , 4.5 years old> DS/PDD-NOS>> [Non-text

portions of this message have been removed]>> >-- Sara - Life is a journey- we

choose the path.

[Guest guest]

Carol,

That's a great idea- yes, 's OT is sensory-certified. His sensory diet at

school consists of swinging, jumping on the trampoline, Benik vest, oral-motor

exercises prior to eating, Wilbarger brushing/joint compressions, etc.

Funny you mention about Trisha not liking anything on her head- is the

same- he finally started to wear a winter hat this year, but will not wear his

equestrian helmet for hippotherapy. Haircuts and nail clippings are very

difficult too.

Thanks for you suggestion,

To: @...: Csvillars@...: Mon, 19 May 2008

19:00:47 -0400Subject: Re: Eye Patching

Does have an OT that is SIPT certified? If so, ask him/her to work on a

sensory diet to help him learn to wear the glasses over time. We had a hard time

getting Trisha to wear her glasses as well and then we got this great OT who

worked up a sensory diet for the many sensory overloads Trisha has one being

wearing anything on her head or neck or arms an now she will wear her glasses

the whole time during school and takes them off to come home. Her eye doctor

said that was fine because it is a strain for her to have to focus her eyes for

so long a period and that unless we are doing school work or something she

really needs to focus she needs her down time without the glasses. The same was

told us by her audiologist about wearing her hearing aids. So we focus on her

wearing them at school and when she comes home she can let her hair down. :-)

She still has a hard time with wearing headphones, she gets upset and will

remove them almost instantly and even at school she has not made a lot of

progress with the headphones. She is now able to tolerate her vibrating watch

for longer periods of time. I am happy with that for now. At least she can see

and hear and have her watch remind her when it's time to go to the bathroom

which is a good improvement. :-) What kind of sensory diet do they use at

school?CarolTrishasmomShe isn't typical, She's Trisha!If we always do what we've

always done, we'll always get what we've always gotten.**************Wondering

what's for Dinner Tonight? Get new twists on family favorites at AOL Food.

(http://food.aol.com/dinner-tonight?NCID=aolfod00030000000001)[Non-text portions

of this message have been removed]

[Guest guest]

nathan had to wear an eye patch after his second eye surgery to fix his " V "

pattern. anyways, it was slow at first bur we just kept leaving it onlonger and

longer, to where he would wear it thorughtout the school day when he was

actually having to focus and use his eyes. shawna

To: @...: brendamcdonnell@...: Mon, 19 May 2008

14:23:20 -0700Subject: Eye Patching

Can anyone share their experience with their child wearing an eye patch?

saw the pediatric opthalmologist today- his farsightedness has increased and he

is now a candidate for eye glasses.However, the doctor recognized that it will

be very difficult for him to wear them, so she said that patching his good eye

is an alternative ( 2 hours a day). is so sensory sensitive, I can't even

see him wearing one for 2 minutes!!Any strategies/recommendations?Thanks in

advance for your wisdom!Best,Mom to , 4.5 years

oldDS/PDD-NOS

[Guest guest]

We patched for years but for different reasons, aphakic amblyopia. There

are a number of strategies and tools for patching success, none of which

are foolproof nor guaranteed. But a few links and a snip from an old

document.

http://www.preventblindness.org/children/EyePatchClub.html

http://ortopadusa.com/sp-bin/spirit?PAGE=24 & CATALOG=5

http://www.fresnelprism.com/MYI.html

*PATCHING*

*Children who wear a contact lens for aphakia will need to have one or

the other of their eyes patched from time to time. Patching an eye

blocks the vision in one way or another, and is often used to

temporarily prevent a baby from using the stronger eye so the vision in

the weaker eye will develop. It may be that the muscles of the weaker

eye need more use, or that the baby's brain needs to practice using the

weaker eye.*

*Blocking vision is also called " occluding, " so you will hear patches of

various types referred to as " occluders. " Your baby's eye might be

patched from time to time using contact lenses, an adhesive eye patch,

or other patching methods (eyedrops, " pirate " patch, or covered

eyeglasses). Each has advantages and disadvantages, and you may use

different methods in combination, or change methods as your baby grows.

Your child will need to follow a patching program until he is visually

mature, usually by 9 or 10 years old, although in the later years he

will only need to patch occasionally.*

*Regardless of the occluding method, you will work with your baby's

doctor to use the schedule he or she recommends. Patching schedules will

change as your baby's eyes develop and change. You might patch regularly

for several hours each day, or patch for one or more days at a time. It

is important not to over-patch, or vision will deteriorate in the

occluded eye! So there is a balancing act necessary to keep vision

developing in both eyes.*

*Staying motivated*

*Your ophthalmologist will tell you that the most important factor in

the development of your child's vision is YOUR compliance with the

patching program. Children do not really enjoy being patched, regardless

of the methods you use, and each method involves some hassle. It is

tempting to put off patching, maybe just for today... and before you

know it, you are really off your routine. It will be helpful if you ask

some other adults to help you stay motivated. Here are some thoughts to

help you stay on track:*

*- Someday my child will thank me!*

*- My child is depending on me.*

*- If my child had a broken leg, we'd use a cast. My child needs the

patch, so we'll do it.*

*- I'd better patch today, because tomorrow may be even more hectic!*

*- When we are in a routine, this is easier for everyone.*

*- Patching will not only help improve his vision, but also eventually

his appearance (keeping eyes straighter), and reduce the likelihood of

needing strabismus surgery.*

*- If I don't do this, my child may end up blind in his weaker eye!*

*- Everybody else has trouble staying motivated, too. I am not alone.*

*- What worked last week will change for this week. That's okay.*

*Occluding contact lenses*

*In order to patch with a contact lens, you can either use a darkened

lens or a regular prescription lens. The dark lenses are not used very

often, because it is hard to keep a consistent coating on the lens, and

because the appearance of the eye with a black lens is not very natural.

It is more common to patch with a regular prescription lens that is

strong enough to blur the baby's vision in that eye, forcing him to use

the other eye.*

*The main advantage of patching with a contact is a social one: during

the months and years when the baby is learning to relate to the world

and developing a self-concept, his appearance will be as close as

possible to normal. There is less explaining to do since strangers

probably won't notice anything unusual about your baby's eyes. Also,

using a contact avoids the skin problems sometimes associated with

regular sticky patch use. The baby can't easily take the contact out and

can't look around it.*

*The disadvantages of using an occluding contact are that you have to

take the lens in and out regularly, as well as care for it properly. You

also must check the child's eye to make sure the contact is in place.

This increases your work, but it may well be worth it.*

*Adhesive Eye Patches*

*When most people think of eye patches, oval adhesive eye patches come

to mind. They are easy to attach and remove, and they are readily

available (pharmacies and most supermarkets carry them, in addition to

opticians). This is the easiest patching method to learn to use. If you

need to buy them frequently, check about bulk prices for a large

quantity. Especially at first, you'll need to keep patches stashed in

lots of convenient locations (diaper bag, Grandma's house, car, etc.)

Adhesive patches are available in a couple of brands and in sizes for

infants and older children.*

*These patches have a few disadvantages. They can be rather expensive

in the long run if you need to replace peeled-off patches several times

a day. (Ask your ophthalmologist to write a prescription for these

medically necessary items, and see if your insurance will reimburse

you.) They are only available in light skin tones, like first-aid

bandages. Wearing an adhesive patch can really be sweaty and

uncomfortable. If your child will be wearing them routinely, try one on

yourself several hours and you are guaranteed to be more sympathetic!

Children occasionally peel off their patches and try to stash them in

the closest hiding place -- their mouth! Watch for this choking hazard.*

Ideas to make wearing patches as cheerful as possible:

*- One brand (Coverlet) comes with little stickers to decorate the

patches (and you could use any stickers you like if this motivates your

child).*

*- One of our children thought it was a great idea to draw an eye on the

patch! Others use a marker to draw a smiley face or " HI " on the patch.

This seems to alleviate some of the pity that strangers feel for a child

in an eyepatch.*

*- As your child is getting used to wearing patches, you might try

applying them before your child wakes up. You won't have to force your

child to be still, and your child may not immediately notice what has

happened.*

*- Ask the child to close both eyes before you put the patch on.

( " Pretend you're sleeping. " ) Her face will be more relaxed than if

she's squinting one eye, and the patch will go on more smoothly.*

*- Let the child try putting the patch on independently. Give some tips

( " Touch only the pad " , " Start at your eyebrow " ). Also, let the child

peel off his or her own patch when the time comes.*

*- Try to put it on when she will be playing with other children or

otherwise distracted.*

*- Be cheerful yourself.*

Hints to minimize skin irritation for routine adhesive patch use:

*- " Paint " the skin around the eye with Maalox (yes, the chalky white

antacid liquid) and allow it to dry before applying the patch.*

*- Rotate the patch or don't attach it in exactly the same place each day.*

*- Occasionally use a gauze square fastened with bandage tape to avoid

irritation to the same area of the skin.*

*- Ask your optician or ophthalmologist about products to coat the skin

before using the patch.*

*- Use an adult-sized patch with the adhesive trimmed in various

patterns from day to day.*

*- Use a different brand patch.*

*- Try a large adhesive bandage designed for knees. These are less

expensive than eye patches, but may not adhere as well.*

Keeping the patch on:

*- Say, " keep your patch on " and replace it firmly and cheerfully.*

*- Cut slits around the patch where it hits her nose so it fits better

and so she can't get such a good grip.*

*- Offer a reward if the child leaves the patch on a certain length of

time.*

*- Patch in terms of time your child can understand. For instance, I'll

say that he may take the patch off when Daddy gets home, or when the

video he's watching is over, or after lunch. (This takes the focus off

begging me.)*

*- Younger children can be kept in mittens so they can't use their

fingers to peel the patch.*

*- After attaching the patch, try wrapping and taping gauze bandage

around the child's head to make the patch less accessible.*

*- Use surgical or first aid tape around the edge of the patch to make a

really thin edge that's hard to peel off.*

*- Make or purchase splints to keep the child's elbows straight. The

child can still play, but can't reach his or her eyes.*

*We have found that the ability for babies and children to tolerate

adhesive patches comes and goes in stages. (The period between 9 and 18

months is particularly difficult for many children.) Being consistent

is the most helpful way to stay on track with your patching. It also

helps to be matter-of-fact and positive about the patch, avoiding saying

things to your child like " I know you hate this, but you have to wear

it. " At some points you may want to alternate with other patching

methods.*

*Other patching methods*

*Eye Drops*

*Atropine eye drops are sometimes used to temporarily paralyze the

focusing muscles in an eye, which " patches " that eye. Atropine is most

commonly used for long-term occluding (days or weeks at a time) or for

non-compliant children, but has some drawbacks. It is hard to tell just

when the drops take effect and wear off, so it is not as " definite " as

other patching methods.*

*Patches On Eyeglasses*

*Particularly if your child is already used to wearing eyeglasses, you

may find it easiest to patch with a felt or leather-type pocket which

cups around the frame of the glasses. From a social point of view, this

attracts a lot of attention, and it must be worn properly so the child

can't peek around the edges. On the other hand, such a patch is very

easy for you to take on and off, and you can easily tell if it is in

place!*

*There is also a patch that fastens to the inside of eyeglasses using a

suction cup, which works well for a compliant child. The inside of

eyeglasses can also be blurred with sticky plastic (like Contac brand

paper or shelf liner). Both of these methods depend on the child's not

peeking around the patched lens.*

* " Pirate " Patches*

* " Pirate " patches (on an elastic band) are not usually used for children

for social reasons and because compliance is so low, but they are an

option if the child is very cooperative. When our son was three years

old, he thought looking like a pirate was really cool! They have the

advantage of being easily put on and removed without the skin problems

associated with adhesive patches.*

Oh, and one final note to anybody who reads this far, when the going

gets tough, the tough get duct tape. -- Bob