I recently diagnosed a lively 5 year old boy with refractive amblyopia. Despite wearing his glasses for several months, his vision in the amblyopic eye had not improved enough, so I prescribed a patching regimen: 2 hours of patching per day with 30 minutes of activities. When discussing the patching with his parents, I stressed the importance of engaging him in a activities requiring the eyes to lead the hands; eye-hand coordination. I then gave them a “handout” listing all types of activities that can be used.
But these parents were far more creative than anything listed on the handout of suggested activities. They immediately began to suggest a large variety of activities and games that they seemed to think their son would enjoy. I loved their enthusiasm and suggestions for making the patching more fun, thereby increasing compliance and ultimately bolstering the outcome…… until mom mentioned her son’s kitchen skills.
My young patient is an up and coming chef! He loves to assist his parents in the kitchen. He is so accomplished in the kitchen that he has his own knife. His mother saw an opportunity for amblyopia therapy by having her sous chef wear his patch while slicing and dicing carrots and celery.
DANGER!! DANGER!! Do not mix amblyopia therapy with knives. I explained to mom that amblyopia is far more than reduced visual acuity. There are many skills that an amblyopic eye and brain do not do well, and that includes food prep and knife skills. Luckily she saw the flaw in her thinking immediately.
Perhaps I should add a disclaimer to the handout which lists activities for amblyopia therapy. Do not allow your child to use sharp objects while patched!
Want to learn more? Here’s the original article that concluded that 2 hours of patching with active therapy is just as good as 6 hours of patching when treating young children with amblyopia.