What eye patching is, how you can help a pupil who wears a patch, activities the pupil can do while patched.

What eye patching is

Patching, also known as occlusion therapy, is a common way to try to improve the vision in a weaker eye when a child has a lazy eye (also known as amblyopia).

The child wears the patch on the better seeing eye for a few hours each day, depending on the difference in the vision in each eye. Some children may need to wear a patch to improve vision in an eye that’s only slightly weaker than their better eye. Other children may need to wear a patch to improve vision of an eye that is much weaker than their better eye. 

If a child can use both eyes together, this helps them know where objects are in space, also known as depth perception.

Children who only use one eye are likely to find it difficult to:

  • judge the height of steps 
  • reach accurately for objects
  •  judge the speed that something is travelling at 
  • judge how far away an object is 

With experience, these children tend to:

  • adapt and learn where things are in space
  • become more confident in familiar settings, for example the home or nursery

However, when they go into unfamiliar places, they may show these difficulties again and are more likely to bump into things or fall. 

Patching can be required for a short period of time (for example 1 hour per day) or several hours per day. The level of vision and the amount of time patching is required, and the need to continue patching treatment will be reviewed regularly.

What you can do to help a child wearing a patch

Whatever the child is doing, they’re stimulating the vision in their weaker eye. Distraction is a useful strategy to encourage the child to wear a patch.

It may be easier to patch when the child can focus on stimulating fun activities rather than learning something new that requires a high level of concentration and effort.

To help a child wearing a patch, you can:

  • use a reward system with attainable short-term goals
  • help the child understand why they need to wear a patch 
  • help other children understand why a child needs to wear a patch, you can also help the child explain to others if they’re asked
  • give the child time to explore their environment including steps and heights keep furniture in a consistent layout as much as possible
  • allow the child to bring objects close to them or to get close to objects or books
  • encourage the child to engage in fun activities while being patched 
  • provide extra supervision when in unfamiliar environments
  • establish a routine: 
    • think carefully when the best time would be to patch, so that the child can engage in activities
    • start with fun activities and once the child is more confident wearing the patch, you can try to have them wear the patch as much as possible whatever they’re doing

If vision in the weaker eye is very poor: 

  • provide books with larger print or enlarge some materials and books: books for young children often have large print and it’s useful to have an example of font size the child can see (check with the child’s orthoptist) 
  • make sure the child is sitting close enough to the teaching focus to be able to see it, for example closer to the interactive white board or to the shared story book

Examples of activities while a pupil is patched

Activities a pupil can engage in while patched include:

  • games that involve drawing a line in between lines, like in mazes to find your way out
  • dominoes where you match patterns or colours
  • peekaboo games: find a picture hiding under flaps or somewhere on a page
  • share a story book: if vision is very poor in the weaker eye, choose books with large bold pictures
  • drawing, colouring and painting are great activities
  • watching a video
  • playing computer or video games or an iPad game

Transition between settings

At transition times between setting, for example from nursery to school:

  • make sure staff in the new setting are informed about strategies in place in the current setting
  • make sure you share any information and advice provided about the level of vision with new setting
  • make sure staff have contact details of the pupil’s orthoptist 
  • establish a routine for patching that will work the new setting

Contact us
Sensory Support Service
Elmfield House
Greystoke Avenue
BS10 6AY

Phone: 0117 903 8442
Text: 07407 814 763
Email: sensorysupportservice@bristol.gov.uk