This question comes from Nicole, whose daughter Penny is 3 months old and has cataracts and possibly strabismus. -Ann Z
With the possibility that Penny might have strabismus, I’ve been reading a bit more about. I’ve been reading about alot of under-1-year-olds that have been patching until they are 6 or even older. Has anyone ever had relatively immediate success with patching, or is it strictly a long-term treatment? What is the shortest amount of time anyone has had to patch, and have it be successful?
For Little Eyes 
Well, we have been patching Ellie since she is four months old, but I can’t say we have had immediate success. To my shame, we have not been consistently patching. One reason is that I felt like she would never learn to walk because of the patch (she was 20 months old before she walked). I strongly believe that it can be very successful if it is done consistently, but it is very hard to be consistent when they are so young, because I just felt sorry for her, but now I have to feel sorry for her because she is 2 now, and still patching. We have been making a lot of progress in the past two months, and for the first time I am actually excited to see how her vision has improved when we go back at the beginning of May. I know this does not answer your question, I just wanted to share our situation and lack of results because of inconsistency on my part.
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hey, We just started with Belle at 4. But Maggie over at amblyopia kids only had to patch for 8 months. That is hopeful for me.
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Corrie, I am finding the same problem with keeping Penny’s glasses on. They don’t do the best they can because I feel bad when they slide and she has trouble breathing, so I take them off. I’ve started trying to force myself to put them on her and leave them on. I can see that being a challenge with patching too.
MT, that sounds hopeful. Our appointment is the 29th, but I just want to get in there now to find out if we need to patch so we can get it started with faster and hopefully over with faster too.
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Did you see the straps that Framehuggers were giving away to test? Maybe that would be an option for helping with the glasses? I’d probably be nervous that it could choke or strangle but she was saying it velcro’d securely on and was breathable – I’d probably try it.
If you do need to patch, I hope you don’t .. But I think it is great you are on top of it. I know how it feels to just want to know and get it fixed as best you can as fast as you can… just drop me an email and I can send you the stash of Junior size patches that we have that would work for a baby but were too small for my just turned 4 year old.
Belle saw a baby wearing glasses recently and she was so happy about it -went right up to the baby and was telling me. “Do you see her glasses”?? As if she was pointing it out to me. Thankfully, the mother was super cool about it. I was just glad Belle didn’t try to take them off of her!!!
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Our daughter’s PO told us that onset of strabismus in an aphakic child is slightly different then regular strabismus, depending on how dense your daughters cataracts were, she probably never processed images from one or both of her eyes, this is why we cannot use atropine drops as a method of patching with our children. Our daughter’s PO told us that Mia will have to patch her left eye until she is about 6 or 7 years old. Our daughter’s case is slightly different than yours since Mia had a unilateral cataract opposed to a bilateral. So her left eye sees fine, and we have to force her right eye to begin seeing. Her brain is favoring her “good” left eye which has created the onset of exotropia. However her vision is starting to improve with the occlusion lens, her visual acuity is 20/980, which is a huge improvement from several months ago. Our daughter’s PO told us that with bilateral cataracts your child will have a better chance for developing binocular vision since both eyes are not competing with each other. Another problem that you need to monitor is the onset of glaucoma and nystagmus. You should monitor your daughter’s eyes to see if they scan back and forth or if she is able to hold a gaze or focus on an object. If you notice your daughter looks at you from a awkward angle, such as her head turned to the side and her eyes all the way to the left, right, up or down; this is called a null point, it is a point were the eyes are able to stay steady and focus, these are all signs of nystagmus. You should inform your daughter’s PO if notice any of these signs. Mia has 2 null points that are all the was to right and left, we call it her side stare. Your daughter’s PO will do regular pressure checks to ensure your daughter’s IOP remains in the teens and she has not developed glaucoma. I think the biggest obstacle with congenital cataracts, is the onset of so many other eye disorders.
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My daughter has amblyopia and has been patching for close to 5 months. We just went to the doctor today and we have had great progress but there is still the likelihood that she will have to patch until she is 6. The doctor said there is so quick fix to this condition and the weaker eye needs time to get stronger. I was surprised that children would have to patch so long, but I guess it makes some sense.
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This is not something I’ve asked our PO and I will put it on my list for next visit. We just seem to go a visit at a time and hope for improvement. Elly started patching about a year ago. It seems like the amount of time spent patching daily and how long it lasts really depends on the individual situation. I REALLY hope we are not patching until 6. =( But, if it means we can save or improve her vision so that she can drive a car, go to college and read the material, and more… we will patch without hesitation.
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I have left a long response somewhere else as well, but patching, our daughter was completely blind in her left eye by the time she was 1 and we discovered her sight problems because her brain realised there was something wrong with that eye (although she is still a +7.25 in the other) and shut it down. She is in the worst 3% for her eyesight. So good news, we had to patch for 9 waking hours every day. We tried the patch that stuck on and I just couldn\’t do it. I made her some pretty \’pirate patches\’ and then found some fabric patches that slip through the arm of the glasses and cover the \’bad\’ eye. With the threat of her essentially being legally blind when I rang her opthamologist telling him I couldn\’t do it because she sat on my lap every day screaming that she \’couldn\’t see\’ (which he quite simply said she couldn\’t), I decided I would do it properly, which I did. We had to patch constantly during her waking hours (except when she was in the bath) until she was about 2, then less hours until she was about 3 and then on and off until she was about 3.5. Not bad really when considering she was completely blind in that eye. Her new opthamologist said she had done a fantastic job and her sight was relatively \’the same\’ in both eyes and puts the success down to the type of patch we used as he finds parents and children don\’t take well to the stuck on patch. Good luck and remember, it is better to do it aggressively when they are young, than when they are at school. I couldn\’t imagine what the other kids would be saying to her if she had a patch at school as kids (and adults mind you) can be very rude. Make it fun and let them decorate their patches and most of all, wear one yourself.
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Glassesmum, thanks for a great story about how persistence and patching can really work. Do you happen to remember the name of the patches you used?
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To the money family, your daughter\’s glasses just look way to large for her. Maybe a smaller pair will help.
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They were at the time, glassesmum. We fell for the “buy a size too big so she’ll grow into them” trick, and learned our lesson. But we got a strap from Camille at Framehuggers (which sounds like the patches that you used for your daughter), and it kept her glasses up admirably.
We have a new prescription now and the eyewear place is trying to convince me that those frames are still ok for her, when they leave major gouges in her temples from being too tight. They just got in 2 different Marchon Flexon frames today for us to go try… heading there shortly. =)
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