Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .
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Yes. She's 5 and I think she doesn't like the patch bc people always stare at her or ask her what's wrong with her eye. It didn't bother her before but now she just won't wear it. I thinking makes her self conscious.
For how long was she advised to wear the patch?
Does she have equal vision in both eyes or is it decreased in one eye only?
They said to try as ling as possible. We have been patching for over a year now. Probably longer.
Her other eye is 20/20.
So the vision in the amblyopic eye is now 20/40 after patching for almost an year ?
The Dr said her eye is perfectly healthy. We just have to train it. No nerve problems or anything like that. They are shooting for 20/30.
Patching is definitely a very effective mode of treating amblyopia but for the inconvenience caused for cosmetic reasons.
I think going from 20/800 to 20/40 is excellent! But I'm scared if she doesn't patch her vision is gonna get worse.
As you have already experienced, cycloplegic medicines such as atropine eye drops can cause prolonged blurring of vision.
Unfortunately other cycloplegic eye drops are not as effective as atropine and are thus not preferred.
The whole idea of this eye drop is to make the vision in the good eye to become blurred so that the amblyopic eye is forced to see. In patching there is an option to vary the duration or hours of patching.
Can her vision revert back to 20/800 since she's patched maybe 2 weeks in 5 months?
Since she is still at an age wherein amblyopia can revert back, it is better to follow the advice of her pediatric ophthalmologist regarding number of hours of patching.
I really think a kid at school said something or made fun of her bc she was ok with wearing it (as ok as a 5 year old can be) then one day she just started taking it off after she got to school.
The entire process of patching can only help upto 10-12 years beyond which amblyopia becomes irreversible.
I can definitely understand how difficult it must have been for such a young child. But we must truly appreciate her for having worn it for so long.
So after she is 10-12 years of age an amblyopia is irreversible? So we still have tIme since she's 5 for it to be fixed and not permanent correct?
We did the rewarded system to get her to wear it. $1 every day she wears it and for a full week we gave her $20. She did good for a whole but I'm guessing when she was picked on it just changed her whole perspective.
Yes, beyond that age it is not possible to correct amblyopia. There is still plenty of time to correct her amblyopia.
Ok. That was a very nice way of coaxing her to do so.
Even now I guess she might continue to wear the patch if we make her realise that.
The only thing that scared me about the atropine is I know it can be dangerous. I read about it and I probably shouldn't have. Would 1 drop daily be dangerous?
I read that it can be toxic and that freaked me out especially when 1 drop kept her eye dilated for almost 2 weeks!
Atropine eye drops can be dangerous especially in children as it can enter the blood circulation directly. But that does not happen with each individual or with every drop. Morever it is normal for the eye to be dilated for two weeks following atropine.
So 1 drop of atropine daily is safe? And nothing to be worrying about?
I know there is other dialating drops...do they carry the same risk as atropine?
One drop can be used safely as long as the side effects of a dilated pupil ( in the form of light sensitivity) are well tolerated.
I'm sure other drops are not as effective but they want to shoot for 12 hours of patching. So is there a drop besides atropine that would give 12 hours of blurring?
Homatropine eye drops are shorter acting but do not induce the same effect as atropine.Its effect can last upto 2 days.
Ok. Thanks for your input! I'm gonna call and schedule her an appointment 2 months out and see how we do. She hasn't been since Feb and was supposed to go back in June. But we cancelled bc she wouldn't patch and I assumed we should try to get in 2 months of patching before going back.
You are most welcome. Yes, it is a wise thing to follow up. God bless the child and take care.