Eye Patches - hints please?

[merrygoround]

I posted recently for advice on getting dd to wear her new glasses and it has all gone fantastically well. Now the patching has to start, and I have a horrible feeling that the stress of the glasses was nothing to what the next stage is going to be like....

She threw a wobbly when the doctor (who is lovely) tried to stick a patch on her eye - and having tried it out myself tonight I can only sympathise. I was really shocked to discover that the patch is not like a dressing up pirate one, but like a large sticking plaster! I've had a trawl throught the archived messages and learnt two things - one is that her eyebrows might come off with the sticky patches, and two, that there are other types of patch out there.

Can anyone give me any further advice? I would be so grateful. By the way, the doc suggested that it might be best if dd wears her patch full time for the 3 days she is at nursery, as she will be busy and distracted. Any extra time I can build in will be good too.

Thanks in advance.

[Yorkiegirl]

Message withdrawn

[merrygoround]

Thanks Yorkiegirl. There are some stickers with the patches which the doctor tried to tempt her with, but I think it may take a bit more than that to persuade her initially, because of the sheer discomfort. Once she's got the hang of it all perhaps the stickers may help more. I'll certainly give them a go.

[frogs]

Hi, merrygoround.

I read that comment on the other thread about the eyebrow coming off in horror -- we never had anything like that!! The leaflet tells you to stick the patch under the eyebrow, which we never quite got the hang of, but it never caused problems with the hairs getting pulled out. Dd1 was always allowed to remove the patch by herself, though.

Don't know about other types of patch -- in the seventies they used to patch the glasses rather than the eye, but this can encourage the child to peer round the sides. I would have thought removable patches like a pirate patch would be pretty useless too.

If I've understood right, your dd is younger than mine was then (5), so reasoning may be less likely to work. But on the upside, she won't be worrying about what other kids are thinking/saying, which was the main problem for us.

I think affecting a breezy 'Here's how it's going to be, now let's get on with it' manner worked best, though it is hard if you're upset about it yourself. I used to tell myself that if she had diabetes I wouldn't expect her to like the insulin injections, but she'd just have to live with it. The younger they are, the more easily they habituate to it, so I'd probably go for a hefty dose of bribery/rewards the first few times, and then tail it off, as the patching became part of the morning routine.

How are you feeling about it? As a treatment it really does work, btw.

[Yorkiegirl]

Message withdrawn

[merrygoround]

Thanks frogs. DD is just over 2.5, so yes, not too bothered by what others think. I agree that the "this is how it is" approach is best - but I am quaking at the thought of the tears. The first few days of glasses (only 3 weeks ago, seems so much longer) I tried bribery, and knew I was in trouble when she came to me, glasses removed, and said "I don't want smarties"! If smarties didn't work, what on earth would? I kept going and by day 8 we were over the worst. So I don't want to assume the worst with the patches, but her initial reaction has been very bad.

[zaphod]

Perhaps try bribing her with a treat for wearing the patch? My dd's eyebrows were not affected by them at all. However we did find that it was a big strain on her wearing the eyepatch, in that it made her tired on the days that she had to wear it, so be prepared for that, and the crankiness tiredness brings.

[lou33]

DS2 wore patches for about 6 weeks. His eyebrow didn't come out, and they came with various assorted stickers that you can choose to put on the patch itself. He tried to pull it off for the first few times, but was pretty good after that. He was allergic to the forst patches he tried though, so we had to switch to non allergenic ones, they are white iirc, but still do the same thing.

[merrygoround]

Thanks for responses so far. For anyone who has been through this, how did your child actually cope with getting around? Did they bump into things, fall down stairs or trip over etc? Will dd need a lot of hand holding simply because of struggling to see with her bad eye?

I just went to a local chemist who didn't sell any patches except a pirate type one. Do most chemists stock the sticky ones? If not, where do you get them from? The ones the hospital gave me are a bit too big (the doctor's opinion), so she suggested I buy some in a smaller size. The ones I've been given are "Opticlude" and say they have hypoallergenic adhesive, but they are brown and look like normal plasters.

[frogs]

Hi again, merrygoround.

Covering up the good eye didn't cause us too many problems from a seeing point of view, even tho' my dd at that time had very little vision in that eye. It does improve quite quickly if you're consistent with it.

The patches do look like big sticking plasters. I can't remember what the brand name was, but they're the ones that come with little red oval reward stickers. We never had problems with allergies, only occasionally a little redness or dryness -- just put some E45 on after you take the patch off.

You get the patches from the hospital, or whoever is supervising the occlusion therapy -- I've never tried to buy them from the chemist. They seem to be pretty much standard issue, and IIRC they come in maybe a couple of different sizes, one for real tinies, and one for nursery/infant-school aged children.

The exact fit probably isn't that critical, as long as you can cover up the eye effectively. But go back to the hospital if you're really concerned about the fit -- any Dr. not specialising in this field won't necessarily be fully up to speed on what the patched eye should look like.

And organise a nice treat for yourself after you've sent her off to nursery with it for the first time -- it is upsetting to see your angel's little face with a horrid great patch on it. But if you stick with it, it'll be over more quickly and she'll have a properly functioning eye again.

hth

[frogs]

Also, wrt the fit, your dd may be just in between the two sizes. I remember thinking my dd's ones were a bit big, and then seeing the smaller ones (I think they gave me a packet by mistake) and they were really wincy.

Too small would be worse, as it would be uncomfortable and get stuck to the eyelid. OTOH, if it's halfway down her cheek, you probably need to get the hospital to have another look.

[lou33]

I always got the patches from the eye clinic.

[merrygoround]

thanks lou33 and frogs. Mumsnet is so great for these situations - I'm feeling better prepared now.

I'll have a go with the large looking patches I've already got, while ringing around for stockists of smaller ones. I'm planning to start patching dd tomorrow.

Not sure whether I'll go for the three full days approach, or try six half days instead - the doctor said it was up to me to some extent.

Despite all the advice I am still dreading it!! At least I know that others have succeeded with getting their children to co-operate, and I guess it's a matter of perseverance.

[Miaou]

My dd had patches when she was 4, for about a year (she was almost blind in the other eye before we started patching ) - we were given a material patch for her to slip over her glasses if she couldn't cope with the sticky patch, and were told it didn't really make much difference which one she had. That opinion could vary from one doctor to another, I suppose, but it's worth asking for one if she refuses to wear the stick-on ones - surely any patching is better than none!

Good luck!

[merrygoround]

Miaou and 006, thanks a lot. I tend to agree that surely any patching is better than none, so will give the sticky things a good chance before trying others. I'll also ring around some hospital eye clinics to see if I can track down some jazzier patches.

[merrygoround]

Just thought I'd report that dd's first day of patching went OK, much better than I expected. I DID patch the bad eye (on advice of doctor) so that she had less to contend with for the first time (ie could use the good eye to see with), but the big surprise was that she let me put the patch on with very little moaning. She liked telling people that she was being a pirate. I'm not sure if she realises that it's not over yet....

Have ordered replacements from Boots after local chemists were blank about getting them in.

On the plus side, it certainly is an attention grabber! I'm sure I'll get fed up eventually, but I was touched when an old lady came up to dd, very emotional, and told her that seeing dd reminded me of when she herself had had to wear a patch, and how horrible it had been. She was so sweet!

[lou33]

That's good news Merrygoround, I hope it carries on being so easy

[Miaou]

Brilliant merry, gives you the confidence to carry on!

[merrygoround]

Thanks miaou and lou! There was more resistance today, but you are right miaou - having had a good day yesterday gave me more confidencce to carry on.

Got a shock when I had to pay for the replacement patches I ordered in Boots - they cost over £8 for one packet!!! We go back to the hospital in two weeks time(it is a slightly strange set up, as dd is being seen at the teaching clinic of a university, so we've had to pay £25 for 6 months worth of appointments, but will be referred on to the NHS as well)- and I'll ask then whether I can't get them on prescription. If anyone is still reading this thread, did you use each patch only once and throw it away? Or did you get a couple of goes out of each one?

[lou33]

I used it once and threw it. I don't understand why you aren't being given enough to see you through until your appointment though, when they should give you more. Have they said why?

[merrygoround]

Well, I think it is my fault. The doctor we saw last week gave me a full box (which will last till the next appointment), but said that she thought there might be a smaller size that would be better for dd, and that I could buy them from the chemist. So I got the impression that the box I was given was because they were being nice, not that we were entitled. In the end I've got the same size anyway (nothing else available, and they seem OK to me), so perhaps I should have waited till the next appointment. I'd also rung the local hospital eye dept, and they told me they could only dispense to patients of that hospital, so I was just panicking a bit I suppose.

[lou33]

Lol. Get some next time you go, children don't have to pay for that sort of thing.

Slight tip, the eye patches make great temporary plasters when one of my brood have cut themselves , and I have run out of proper ones!

[woodstock]

I know of some mums who have made their own patches using felt with various decorations on front and an elastic strap like the pirate patches. There have been some recent studies that confirm as little as 2 - 3 hours of patching a day works as well as the longer periods of time previously recommended. You might want to ask about that as it helps if they don't have to wear them to school, etc. I think, if you go with the shorter wearing time route, it's good to try to line up lots of visually stimulating activities such as fingerpainting and such during that time.

[merrygoround]

Woodstock, that is really interesting. The doctor we see said that there is current research into patching therapy, and I got the impression that it was all a bit vague. She suggested dd wear her patch three full days a week while she was at nursery (on the theory that she will be busy and therefore distracted), but when I asked if we could go for seven half days instead of three full ones she said it was up to me. I asked if it was a case of the more the merrier (merrier maybe not the best word...)and she said yes.

Until I read your post I guess I was thinking that if I did full time patching 7 days a week that would be best. But now I think that I'll aim for mornings only on her 4 non nursery days, and just for 3 hours; and if she keeps it on all day at nursery that is fine. Luckily at 2.5 there is not too much worry about her suffering teasing from other children.

Do you know where I could find the research? I'd be interested to read it?

[woodstock]

I will email my friend who told me about it and get the source for you. I do know that it works however as I have tried it with quite a few patients over the years even before the study came out with good results. Glad I could help. Amblyopia prevention is a bit of a passion for me!