Occlusion therapy is a treatment designed to improve vision in an underperforming eye. By covering the stronger, or dominant, eye, the brain is forced to use and strengthen the neural connections responsible for sight in the weaker eye. This therapy retrains the brain’s visual system, promoting the development of clearer vision over time by restricting input from the eye it naturally favors.
Conditions Treated by Occlusion Therapy
This therapy is a primary treatment for amblyopia, commonly known as lazy eye. Amblyopia is a neurodevelopmental condition where the brain and one eye do not communicate effectively, causing the brain to favor the other. This results in underdeveloped vision in the non-favored eye, even if the eye is structurally healthy. The brain learns to ignore blurry images from the weaker eye, which prevents the related neural pathways from maturing properly.
The treatment is most effective in young children because their brains have a higher degree of cortical plasticity, meaning they can adapt and form new connections more readily.
Another condition that often leads to amblyopia is strabismus, or misaligned eyes. When the eyes are not aligned, they send different images to the brain, which can cause double vision. To avoid this, the brain may suppress the input from the misaligned eye, leading to amblyopia. In these cases, occlusion therapy is used to treat the resulting amblyopia, though it does not correct the physical misalignment of the eyes itself.
Methods of Occlusion
The most traditional method of occlusion is the use of an eye patch. These come in two main forms: adhesive patches that stick directly to the skin around the eye and cloth patches designed to be worn over a pair of glasses. Adhesive patches ensure a complete blockage of vision from the dominant eye, preventing peeking. Cloth patches offer a reusable and often more comfortable alternative for children who wear corrective lenses full-time.
An alternative method involves the use of atropine eye drops. These drops are administered to the stronger eye to temporarily blur its vision, particularly for near tasks. This blurring effect makes it more difficult for the brain to rely on the dominant eye, thereby encouraging the use of the weaker eye. Atropine is often considered when a child has difficulty with or refuses to wear a patch, as it provides a less invasive way to achieve a similar outcome.
The Treatment Process and Compliance
The duration and intensity of occlusion therapy are tailored to the individual child, depending on their age and the severity of the amblyopia. A typical prescription may involve patching for two to six hours per day. The overall treatment can last for many months or even several years, with regular follow-up appointments to monitor progress and adjust the plan. The goal is to continue the therapy until the vision in both eyes becomes equal or until improvement plateaus.
A significant challenge in occlusion therapy is ensuring the child adheres to the treatment plan, known as compliance. It can be difficult for children to understand the necessity of covering their better-seeing eye, which can lead to resistance. To improve compliance, parents can employ several strategies to make the experience more positive:
- Decorating the patches with stickers or drawings to make them more appealing to the child.
- Establishing a routine where “patch time” is associated with enjoyable, quiet activities like reading or drawing.
- Reward charts that track successful patching days can provide motivation.
- Maintaining a positive and encouraging attitude, as children often mirror the emotions of their caregivers.