Eye patching - v. slow progress

[Pammym]

We have been patching DD's lazy eye 3 hours a day since Feb/March but after several check-ups, the latest being Tuesday of this week, there is still not much progress. She is able to see down to the 3rd line of the chart with the bad eye(just!). The orthoptist said he would have expected more significant progress.

Her glasses prescription has been tweaked to try and improve the focus in her bad eye and the prescription in her good eye has been made a bit stronger to try and balance the eyes up a bit. We are to try new glasses and continue 3 hours daily patching and see if that helps. If not, the orthoptist is talking about electrode testing to measure the brain's signal to the lazy eye.

I am so very worried and wondered if anyone has any experience of this at all.

[DBennett]

How old is DD?

It's a bit unusual for the effect of patching to be measured on an adult chart (which has multiple lines) rather than flip-over cards (with only a few letters on each side).

Where is she being managed?

How long was she wearing the glasses before patching started?

[Pammym]

Hi. DD is 5 (6 end of Sept). She started wearing glasses last Nov and the patching started end of Feb/beginning Mar. She is being managed at Salisbury District Hospital. I must say that she was able to see more letters when the orthoptist did eventually get out the flip over cards than when she was being asked to read off the adult chart.

I didn't realise it wasn't usual to use the standard charts for kids undergoing patching?

[DBennett]

All the guidance I'm aware of advises the flip-over cards, using them enables more accurate monitoring of a treatment effects, amount other things.

In fairness, they're better for children in general.

Generally speaking patching needs to be done for about 200hrs to get the maximum improvement but this can happen in fits and starts.

Assuming patching/glasses are being complied with then it is worth making sure there is not another reason why the vision might be down.

The test mentioned sounds like electro-physiology which measures the electrical signals generated by the eye.
The results can help determine whether the vision is down due to amblyopia (lazy-eye) or some other, likely subtle and non-sinister, reason.

Stick with the glasses & patching and see if there has been an improvement at the next visit is all the advice I can give you.

[Pammym]

Thanks for that DBennett. I did wonder if there was a chance of the odd gap appearing in DD's cloth patches around where the patch fits over the nose piece so I have started putting a sticky patch over the top of the glasses as well. Also really hoping that the new glasses will help. Think I will ask the orthoptist about the flip over cards at our next visit too.

[Karoleann]

It does take a bit longer in older children. Try her doing more visually stimulating tasks with the patch on - computer games are good. Or detailed drawing, colouring in - that sort of thing.
It may be worth increasing the length of occlusion each day - but I would get things checked further.
(Carole - Optometrist)

[Pammym]

Thanks Carole. I am getting her to play on the computer and draw for some of the patch time. I am also trying to increase patch time but am only managing it by 10 or 20 mins extra.

[Claire9527]

Sorry, I know this post is from a long time ago but I am just wondering if you could tell me what happened with your daughter, and how her eyesight is now?
Your DD sounded to be exactly the same as my DD now. She's making very slow progress and has done patching for 3hr a day for 14 weeks now. We have her review appointment next week and I'm starting to worry.