AboutDr Anand Shroff, MD, FICS Expertise I can answer any question on eye care, expertise in Laser eye surgery, LASIK, Epi LASIK, cataract, glaucoma, keratoconus- corneal collagen crosslinking.
Experience OF LASIK, we are one of the first centres to use the wavefront guided LASIK or custom LASIK procedures. I train doctors worldwide for these wavefront procedures, our centre is the referral centre for our Wavelight Laser Technologies, Germany in India.
Organizations ASCRS [American Society of Cataract and Refractive Surgery]certified by USA- Joint Commission International
Publications http://www.shroffeye.org
Education/Credentials MD Ophthalmology and FICS [Fellow of the International College of Surgeons]
Awards and Honors please see http://www.shroffeye.org and www.lasikindia.in
Expert: Dr Anand Shroff, MD, FICS Date: 7/1/2008 Subject: Patching for left lazy eye, strabismis and long sightedness
Question QUESTION: My son has been patching since he was 2 years old, he is now 5 years old. He has very good control of his squint now, which is virtually unnoticeable, but for the last 6 months, there has been no real improvement in his left eye sight. His visual acuity is left eye 6/12 and right eye is 6/6. He is currently wearing glasses left eye plus/650 and right plus/2. How long do we have to continue to patch. To complicate matters, he was being treated by a pediatric ophthalmologist in London, but we have recently moved to Beijing and seeing a local eye doctor who has suggested drug treatment if there is no improvement with his left eye sight in the future!
ANSWER: Dear Mei,
The patching can be continued till the child is 7 to 9 years old. I do not know of any drugs or medications to cure this...please tell us the name of the treatment that your doctor in Bejing is suggesting.
Orthoptic exercises will help strengthen the visual acuity, look for an optometrist who practices orthoptics with children.
You will need to push all buttons till your child is 9 years old to help him see better as after age 9 years, the visual acuity gets fixed and cannot iprove, hence all attemts should be made to improve acuity till then.
Hope this helps,
Regards,
Dr Anand Shroff, MS (OPHTH), FICS
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: Hi, thank you for your prompt answer, I don't know the name of the drug treatment, but we will see the doctor after the summer. To be honest, I was totally surprised when she suggested it. With regards to the patching, we are currently patching all day, but can the numbers of hours be lessened. When we were back in the UK, after 2 and half years of patching 6 hours daily, we were told we could do 3 hours of patching as long as during those 3 hours, he was doing close up activities. My son is due to start grade 1 at a new school, and I am concerned that he might be picked upon because of his eye patch. Children can be especially cruel. Mei
Answer Dear Mei,
The only drug treatment I can think of is when some doctors put eye drops in the good eye which makes the vision of this eye hazy, so the child is forced to see with the weaker eye, works kind of like 'patching' but not very effective as the eye (with drops) still gets stimulated with light. Patching works more effectively in our experience.
3 hours to 4 hours of 'patching' is what is required to be effective. But this need not be during school hours and can be done at home, when he is doing some activities at home. The recommended games / sports to help tstimulate the weak eye include 'ball games or sports requiring a ball such as Tennis, Baseball etc so that this improves his steroscopic (3 dimensional vision) and body to eye coordination.
Even work such as, doing puzzles and mazes which improves the linear activity. You may also give him multicolour grains and ask him to segregate the same, string beads in the thread etc.
Ideally he has to see the doctor every month or at least once in two months to see his progress.
The doctor may want to give some synaptophore exercises, however, the above exercises will help.
Hope this information helps.
If in Mumbai, India, our Optometrist trained in this field would help you.
Regards,
Dr Anand Shroff,MS (OPHTH), FICS
www.shroffeye.org
Dr Shroff
