Reader questions: a contact lens for amblyopia, and weaning off the patch

Lindsey wrote in about her 3 year old wondering if any parents have faced, or are facing a similar situation. Does anyone have experience with a large difference in prescription between the eyes, and either successful weaning from a patch or using a contact lens. – Ann Z

Elise has intermittant strabismus and has anisometropia (large difference between prescription in her eyes). Her right eye is +5 and her left eye is Plano (or no prescription)

We patch 2 hours a day and have been since may 2012. We fully recovered her vision (yay!) Then the doc cut back patching to every other day. This was unsuccessful and we’re back onto every day 2 hrs patching again…sigh. Her vision is fully recovered again however now her right eye more dramatically drifts up, which we hadn’t seen any signs of since before glasses. (I’m definitely interested in patching weaning experience stories if you know of anyone who has successfully worked their child off of the patch for good.)

Our doctor’s next step is getting Elise into wearing a single contact which is our most hopeful option at developing her stereoscopic vision (we don’t know how bad it is yet since she’s only 3 and can’t really tell us what she can/cant see yet). The contact lens sitting on her eye will drastically improve the image size difference between her two eyes which right now is a rather large difference due to her prescription. It’s definitely a journey to say the least!

6 responses to “Reader questions: a contact lens for amblyopia, and weaning off the patch

  1. My daughter has strabismus and had amblyopia in one eye. We never patched, except during eye exercises for vision therapy. The comment I wanted to make is at 3, they should be able to test for stereopsis. My kids were both tested at that age at the pediatrician’s office, using 3d glasses and some kind of dot image where they are supposed to see a butterfly. Good luck. The contact lens sounds great. Good luck!


  2. My daughter has anisometropia due to cataract removal. She has been in a contact since 3 months old. It is daunting to think of an infant or child wearing a contact, but it is very doable. And at a +5 prescription, they shouldn’t be super expensive. Our daughter’s eye drifts in and up due to the severe difference, but is much better when she has correction. I konw our PO probabaly won’t discontinue patching until age 7 or 8 when vision is fully developed. I know for “moderate” amblyopia, you may be able to discontinue after vision is restored, but with a big difference in the eyes, you may have to patch for a long time to maintain the vision while she continues to grow. Just a thought… Good luck as you continue your journey!


  3. My daughter had both her lenses removed, at age 3, as they weren’t sitting in centre of eyes causing severe eyesight problems. She has been wearing contact lenses since age 3, at first we were totally overwhelmed by the thought of having to put contact lenses into our young child and what effect this would have on her life. We’re happy to say the contact lenses have had no adverse effect on her life, and as long as she is wearing them, she has great vision, only wearing glasses for reading. She is doing great at school, is a true athlete, loves singing and dancing in her school productions. She is amazing on the computer and at the ripe old age of 9, she takes her lenses out and puts them back in her self. Swimming lessons were the only thing that were a little bit of a struggle as we wanted to destroy her lenses after each lesson to minimise the risk of infection from the water, and this became expensive. Luckily in Scotland, we have a wonderful national health service who provide her with a never ending supply of lenses and aftercare. I wish your little girl all the luck in the world, and to you her parents, try not to worry too much, easier said than done, I know. Children are just so resilient and cope with their conditions much better than we adults probably do.



  4. We have been dealing with anisometropia with our son since he was an infant. Currently he has a difference of about 9.5 (Plano and -9.5), but early on the difference was much greater (13). While he has not weaned off the patching (he patches ongoing for 3 hours a day), he’s had stereoscopic vision for some time. Puzzling as it seems he was somehow able to do so despite the large differences, which we and Dr attribute to the resilience of the brain to ‘teach’ itself to accommodate the visual input from both eyes. The key to success from our end has been persistence with the patching routine. Can’t say when the patching will stop, and although each experience is different, it is doable.


  5. Funny you should say about the patching George. Paris my daughter is five, and she has quite a difference between her eyes also. Her current script is -3 in right eye and +1 in left. We were patching daily for a couple of years and vision was equal in both eyes so doc said to wean off it. We went back yesterday and she has slipped back a couple of lines so we are back to patching. I am a big believer in it. It works. He said she may have to patch until 10 but if that is what it takes then that is what we will do. It is worth it in the long run. Does your son have any exotropia (drift outwards) in his short sighted eye? Paris has a mild drift when glasses are off and she is tired but it is not very noticeable. However, as she has slipped a couple of lines on the eye chart and she has been looking over the top of her glasses it’s amazing how her drift has also gotten a little worse 😦 so we are back on track again with patching. In regards to a contact. We did try this and we ordered them however Paris was unwilling to put one in. She was very keen at the idea but when it came to fitting it she freaked out! Understandable as such a young age but we will give it another go next year.


    • Ingrid,
      Interestingly, he has never had any drift. Then again, with few exceptions he’s always patched. I think thats been the key. We stopped once for a couple of months and he slipped back as well.


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