Poor toddler eyesight - Eye patch or drops

[MrsRose2018]

My 2.5 year old has been seen by the eye hospital since he was 1 year old. First for a strabismus/squint In his left eye and now, in addition to and unconnected to the squint, very poor eyesight in his left eye.

He's just been for his consultant review and they have said that we've got a decision to make.

Basically the eyesight his right eye is well above average but the left is really poor and we need to fix this by the time he’s 7/8, otherwise that’s his eyesight for life.

To try and strengthen his weaker left eye and make his right eye less "dominant" we either need to have a patch on his right eye for a minimum of 2 hours a day every day, or we add drops twice a week which make his left eye catch up/work harder by making his right eye blurry.

Our Son already wears glasses so I'm just not sure which approach to take - the patch or the drops. Does anyone have any experience with this or any advice to give?

TIA x

If they're both equally effective, it really depends on how well he tolerates each method. Getting eyedropper into a toddler would be terrible, but making them wear an eyepatch when they don't want to can be tough too.

If he wears glasses can you patch some glasses? Maybe he would tolerate that.

My DS2 wore a patch from age 1 to age 8 from 1-2 hours per day and completely recovered the sight in his affected eye (which was zero at one point and they thought it would never be better than 75%) I found the patches great because you can get different design ones and charts that you stick the patches on after they've worn one. Every time he filled up a chart he got a reward which was a great motivator for him. Honestly eye drops are a pain to put into children's' eyes and I think I would fine it distressing to have blurry vision whereas you don't really notice the patch once you get used to it. So I would say go for the patches.

I would suggest trying the patches, you can always coaches to drops if you struggle but kids tend to just forget the patch is there. My ds was admittedly a little older but had patches and they worked very well. We were told that for best result it should go over the eye but if he didn't tolerate it then we could use it to black out his glasses on that side instead. He was fine with it over his eye though. Still has milk bottle thick glasses at age 16 but his eyes are equally shit and work together which they didn't do when he was little and needed patches!

I've never heard of the drops being used. My DS had patches for almost 2 years from age 3.5. They worked really well. And he did just forget about it. It was normal for him to have them.

It's terrible trying to put eye drops in a toddler. I failed miserably with that and had to go back to chemist to exchange for ointment.
I'd advise the eyepatch

My son tolerates his eye patch very well, and has his favourite patterns which he likes to choose from the box. I wouldn’t like to do anything which would affect the vision of his stronger eye.

Thank you so much for all these responses.

So my next question. Can anyone reccomend a patch that won't hurt his skin taking it off/pull at his hair/eyebrows?

Alternatively would this work? I wasn't at this appointment as my husband took my DS so I didn't get to ask all these questions 😂

If you’re with the NHS they will provide him with boxes of patches, they come in different sizes. The brand I’ve seen are called Orthopad. They are quite sticky so I let my son take them off himself, so he can do it at his own pace. He’s usually keen to take it off so he doesn’t mind that it pulls a bit.

If they're too sticky you could try sticking it to your arm first and then over his eye so it isn't quite as sticky when he removes it.

Drops weren't offered but we used patches for up to 6 hours a day from age 2 to 7. Which ever you choose I would start ASAP as the sooner you do, the better the impact.

I'd try the patches first too.

The poor vision is actually connected with the squint. What's happened is that the brain has switched off the vision in the squinting eye, to prevent him seeing double all the time. Because eyes need to have experience of seeing something to work properly it just hasn't developed properly