To patch or not to patch?

I recently read a book (Crossed & Lazy Eyes) written by an optometrist Dr. Pilar Vergara Gimnenez. She had a very good example that I would like to paraphrase for you. She was talking about the importance of using our two eyes together. When one eye dominates the other eye it sometimes can cause an eye to turn or become a weaker “lazy eye.” Many times doctors rely on patching to try to give the “weaker” eye a chance to develop.

Why I don’t patch (often)

Let me preface by saying sometimes I do patch. But when I do it is for short periods of time and alongside active therapy. Let me reiterate; short time, 15-20 minutes. Many times parents bring their children to us when they need a second opinion. They tell us they have been patching every day (8-10 hours a day) for a year with little to no change. But, I’ve digressed, let me return to why I prefer vision therapy over patching and this brings me to Dr. Gimenez’s (paraphrased) example:

Suppose there are two children. One is a bully and is dominating, the other who must learn to be submissive or suppressed. As long as the two children are in the same room, this behavior exists. To give the “weaker” child a chance to play, talk, etc, you would separate the children into two rooms. Now the second child is free to play as he wishes. However, as soon as the first child enters the room, the situation changes, the first child is still more dominant the second child becomes submissive again.

This is how patching works. As long as there is no conflict, the weaker eye has a chance to “see.” As soon as you remove the patch, the dominant eye takes over and you’re back to square one.

How can you help the weaker eye? We do this by training to the eyes to work together. Both eyes can learn to get along, with the help of vision therapy. During therapy we train the eyes and brain how to “talk it out,” to communicate more efficiently. We give each eye an equal opportunity to “see” and work together to develop binocular vision, or “3-D” vision. Doesn’t that sound nicer than wearing a pirate patch? “Aye aye matey.”

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