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My child has a "lazy eye" (Amblyopia). Is an eye patch really needed? PART 1

Updated: Dec 1, 2020

Maybe you stumbled on this post because you are an adult living with amblyopia.

Or maybe you have a child who was recently diagnosed with the condition.

You may have been told that your child needs to wear an eye patch, using one of the following protocols:

  • All day

  • 6 hours per day

  • 2-4 hours per day

In any case, you might think to yourself,

"This sounds a little extreme. Forcing a child to wear a patch to cover up the eye he/she can see through normally ?

How does a child function?

There must be some other way."

If you've had those thoughts, you may be on to something!

What is Amblyopia?

vision therapy at Optometry office in Bellingham wa
Child performing 3D vision therapy activity used for Amblyopia

First, let's define amblyopia (i.e. "lazy eye") just to make sure the words we use are clear.

Amblyopia is when a person sees worse than they should normally see out of either one or both eyes after the corrective lenses have been attempted.


  • You might be amblyopic if you wear glasses and cannot see normally out of one eye or both eyes.

  • You also might be amblyopic if you don't need glasses. In this case, you eye doctor probably measure zero or very little nearsightedness, farsightedness or astigmatism. You might have an eye that drifts apart from the other eye.

There's a lot of ways you might become amblyopic.

But just know that the poor vision in this condition is not due to a disease...

It's due to either a need for a strong prescription or an eye turn (strabismus). In rare cases, it's due to deprivation (think babies who spend their formative years without exposure to needed visual input).

So what do we do?

"Do I really need to patch the eye?"

If you ask most people, they'll say that the child needs to be patched. After all, this is the conventional method that's been used for hundreds of years.

From the journal, Binocular Vision & Strabismus Quarterly:

"Treatment of amblyopia has basically not changed since occlusion therapy of the sound eye was introduced in Europe during the mid-eighteenth century. While this might seem to suggest that the therapy is completely satisfactory and therefore requires no critical analysis, familiarity with its use in the clinic suggests otherwise."

That is impressive.

A treatment that has stood up to the test of time for almost 300 years!

Patching the "sound eye" as they say, has certainly had a good run.

But why does the author from the article quoted above say that patching needs to be analyzed further?

Answer: Because they found that the effects wear off!

From the same issue of the same journal:

"After successful occlusion(patching), at what rate does that vision achieved by arduous effort by the child and the parents decline?"...

"Using the type of analysis developed for plotting cancer survival, it turns out that 73% of successfully treated amblyopes maintain vision for one year, 61% for two years, and 54% for three years."

So only about half the patients who patch maintain their improvements after three years.

Granted, no optometrist or ophthalmologist expect perfects results for every patient, every single time.

However, if almost 50% lose their improvements after only 3 years, it's time to reconsider this age old patching regimen for amblyopia.

In my next post, I'll discuss less invasive, less obstructive treatments to amblyopia that may in fact have longer lasting effects.

Stay tuned for the alternatives that are available for "lazy eye"/amblyopia treatment.

If you are more interested in this because of a turned eye, then read this E Report on "Lazy Eye" that I've written that will help guide you on what to do next.

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