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What Patching Can and Cannot Do
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- čas přidán 7. 02. 2024
- So many people will try to sell you a quick or easy fix for strabismus and I’m here to tell you that there isn’t one easy solutions. There are different therapies, surgeries, technologies and strategies with different professionals promising results.
In these videos I’m bringing clarity to what can and cannot be done with surgery, vision therapy and patching.
For help, free downloads, my courses, and all the other resources that I have, go to learn.strabism...
Wow! Your results are just fantastic! No one can tell you have had a surgery. Congratulations and I hope the results stay like these. May God bless you!
I felt that patching only rotated the eye turn, but I got use to what full binocular vision felt like. This helped with keeping the patched eye in a "non-wandering" position.
I think patching can be useful as preparation for some other kind of vision therapy. It can relax existing adaptations to strabismus.
For instance, if suppression is a problem, when I block one eye I'm no longer suppressing it-there's no information there to suppress. For an hour or two afterward, suppression is weakened noticeably. So that's a window of opportunity in which my plasticity is a little higher.
Or, after eye muscle surgery that got my eyes about 3/4 of the way toward alignment, I noticed that my eyes would be visibly more crossed after driving somewhere-avoiding diplopia moves up the priority list when driving, so my mind adapts by turning up the suppression and turning one eye further inward to make suppression easier. Very bright light seems to have the same effect, though I'm less sure why. (I've also had a habit, for decades, of closing one eye in these contexts.)
I'm an alternating esotrope so, while my left eye is weakly dominant, I don't understand the dynamics involved in amblyopia. For me, though, "patch the dominant eye" makes some intuitive sense but can be counterproductive. If the goal is weakening suppression, it's actually better to block the non-dominant eye. "Blocked" means "not suppressed". I tried blocking the left (weakly dominant) eye for a week or two, before I figured this out. Over the last few years I'd developed a slight hyperphoria of the right eye when using the left (but no hyper- or hypophoria of the left eye when using the right), and that became amplified a little after blocking the left eye for a few days in a row. On the other hand, if I block the right eye, the hyperphoria is reduced-it's an aid to suppression, it reduces when suppression is unnecessary.
So, when you mention patching decreasing coordination-yes, and that's helpful *if* the kind of coordination you're reducing is a barrier, as is the case with suppression. If you've got some functional binocular vision, it's a risk. If you don't, it might relax one of the barriers.
How can I find vision therapy in my area?
Just go to strabismussolutions.com/findvt/ and I will send you personal recommendations!