Comfortable. solution. The. sensitive problem. your guide to understanding and treating amblyopia, strabismus and visual abnormalities

Transcription

1 3M TM Opticlude TM Orthoptic Eye Patch Orthoptist & Parent Handbook The Comfortable solution to a sensitive problem your guide to understanding and treating amblyopia, strabismus and visual abnormalities 3

2 Product Information 3M Opticlude Orthoptic Eye Patches are designed and custom engineered for the treatment of amblyopia, more commonly referred to as lazy eye. Amblyopia can develop as the result of common childhood conditions such as strabismus (squint/cross eye) or refractive error (need for glasses). Tried, proven and trusted through years of use by Orthoptists across Europe, Opticlude orthoptic eye patches provide a comfortable treatment solution to amblyopia. Worn over the preferred eye, the eye patch encourages the weaker eye to function and the vision to develop. Breathable, hypoallergenic and latex free, Opticlude patches are easily applied and removed with minimal skin irritation. A central, absorbent pad also reduces stickiness from eye secretions. Opticlude Boys and Girls orthoptic eye patches now offer new and exciting designs in both Standard and Junior sizes, providing a more interesting and engaging option when treating signs of amblyopia, strabisumus and undertaking occlusion therapy. The Anatomy of the Eye Iris Pupil Eyelid Sclera Vitreous Humor Retina Macula Fovea Optic Nerve Inferior oblique muscle Inferior rectus muscle The eye functions much like a camera with two lenses. The first lens is the cornea, a clear membrane that covers the front of the eye. The second lens is the eye s natural crystalline lens, which is located behind the pupil. The cornea is responsible for about 70 percent of the eye s focusing power, while the natural lens fine-tunes the image before it is focused on the retina at the back of the eye. If both lenses Superior rectus muscle Superior oblique muscle tendon Lens Iris Pupil Cornea Conjunctiva Sclera are working properly, the image is focused precisely on the surface of the retina for a clear, crisp picture. The retina works like the film in a camera, receiving light images and sending them through the optic nerve to the brain. The visual cortex in the back of the brain combines the two images into a single picture for binocular (twoeyed) vision.

3 Your Child s Condition Explained Amblyopia Amblyopia is the most common cause of poor vision in children with an estimated prevalence of 1-5% 1. A lazy eye is caused by an interruption of normal visual development during childhood, resulting in poor vision of the eye. The visual system develops during childhood, with most development taking place in early childhood. Amblyopia needs to be treated in the early years of childhood, as once visual development is complete, no treatment can be given. If amblyopia is not treated in childhood it could lead to permanent loss of sight which cannot be corrected in later life 1. It is not always obvious that a child suffers from amblyopia; therefore it is important that the child is examined by a trained eye professional. National eye-test programmes vary from region to region and are usually performed at school entry, at the age of 4 or 5. Where there is no local vision screening available, the child can still have an eye test free of charge on the NHS with an Optometrist. Signs of Amblyopia Even though the condition may not be obvious, symptoms may be recognised according to the way the child plays. The child may be quite clumsy, knocking over objects, not be able to grab objects thrown to them or walking into things. These indicate that their depth perception is not optimal. Furthermore, they may be tilting their head to one side which might show an eye muscle imbalance. Strabismus Any condition that affects normal visual development or use of the eyes may cause amblyopia. The most common cause of amblyopia is strabismus, also called cross eye or squint. Strabismus is an imbalance of the position of the eyes which causes the eyes to turn out (exotropia), turn in (esotropia), turn up (hypertropia) or turn down (hypotropia). Amblyopia can also develop if a child needs glasses, especially if there is a difference in the glasses prescription between the two eyes, or where a cataract (abnormality of the lens of the eye) occurs.

4 Treatment Therapy Amblyopia can be treated by using an eye patch to cover the good eye and force your child to use their lazy eye. The aim of this treatment is to encourage the lazy eye to start working and stimulate vision. This then helps the part of the brain that manages sight to further develop. The patching can last from a few hours a day to all day patching, and treatment can continue for a few months or for several years, depending on the severity of the condition and the compliance of your child. It is therefore very important that prescribed treatment is followed and that your child is encouraged to wear the patch. Don t give up! The beliefs that children with amblyopia do improve during treatment is substantiated with evidence 2, 3. Treatment of the amblyopia itself involves stopping the healthy eye from seeing temporarily so that vision is stimulated in the lazy eye. The most common treatment used is occlusion therapy, also known as patching. Application & Removal Application The 3M TM Opticlude TM Orthoptic Eye Patch should be applied to a clean, dry area of skin with the eye closed and face muscles relaxed. The eye should remain closed so that the whole eye area can be covered. Remove the protective paper and gently apply the Opticlude eye patch, with the narrow end towards the nose, ensuring that the adhesive part of the pad is in contact with the skin. Make sure your child cannot peep around the outside of the patch! Secure the pressure sensitive adhesive tape by applying light pressure with fingertips around the outside of the eye patch. Opticlude eye patches are single use products and should be changed according to the prescriber s recommendation. Should your child have sensitive skin, consider using 3M Cavilon Durable Barrier Cream around the eye socket to prevent any possible redness or irritation. Removal Starting at the nose side of the patch; slowly peel back the edges toward the centre of the pad loosening the outer edges of the eye patch. Gently peel back the pad and the remaining tape, ensuring this is done so that the patch is pulled back over itself and kept close to the skin. Removing the eye patch at an angle will pull the skin surface and increase the risk of redness and irritation. As the patch is removed, continue to support the newly exposed skin.

5 For a patch that is strongly adhered, you may consider using a medical grade adhesive remover or moisturiser (approved for use around the eye) such as 3M Cavilon Durable Barrier Cream, to soften the adhesive along the peel edge. Fun Activities whilst Patching Tips for Patching Compliance! Helping your child understand why the patch is needed affords them not only education, but gives them additional motivation. In order to help your child comply with their patching schedule, reward, support, and reassure them so that he or she can develop the best vision possible. Detailed below are a selection of top tips compiled from experts and us here at the Opticlude team! Information is Key! Providing information for not only your child, but also friends and family, is an effective start to ensuring patching success! Talk to your child prior to beginning any patching regime. Explain as best as possible that the patch is needed to help improve their vision in the affected eye. Get family and friends on board by explaining your child s condition to them and ask for their support. They may even offer new suggestions on how to help make the treatment successful. Make sure you explain your child s condition to nursery staff or teachers if your child is in day care or school. Often they will be very helpful in explaining why your child is wearing the patch to classmates or peers. This will greatly elevate the level of acceptance and can help your child feel more comfortable about wearing the patch at day care or in school. Establish Clear Ground Rules Try to avoid power struggles over patch wearing times by setting clear guidelines and realistic expectations. Your child will probably be more receptive if there is some sort of limit on patch wearing time. Your orthoptist or doctor should tell you when your child must wear the patch and for how long. Try to explain this schedule to your child. Set clear outlines regarding the consequences around removing the patch, as well as rewarding the child for keeping the patch on without complaints or difficulties. Consider introducing a rule that only parents (or caregivers and teachers) can touch the patch when it is on. If your patching schedule requires your child to wear the patch for only part of the time, use a clock or a timer to mark when the patch is put on and when it can come off. This will give your child some well-defined limits and can also help avoid making you the bad guy for making sure the patch stays on for the required time.

6 Be Supportive Wearing a patch can be difficult and uncomfortable. By providing support and reassurance, you can help your child comply with their occlusive patching treatment. You can use the 3M TM Opticlude TM Reward Certificates (downloadable from to give children incentives for patching. (Please visit our website for more details). Encourage support from family, friends, and classmates. Offer suggestions on ways they can help make the treatment successful. 3M, the maker of Opticlude patches, is driving patch acceptance through hosting a number of Patching Parties, at orthoptic and ophthalmic departments around the UK. Please visit our website, or ask your local hospital for more details. Orthoptists can also enter competitions to win sponsorship towards hosting their very own patching party. Simply subscribe to either the British and Irish Orthoptic Society (BIOS) or the International Journal for Ophthalmic Practioners (IJOP) and keep an eye out for competitions! Try to make Patch Time Fun! Joe and Rosie, our cartoon parrots love wearing their patches and they would like your children to as well! Try to associate fun activities with patch wearing and perhaps, in some cases, restrict some fun games to be played only during patch wearing times, so that your child associates patching with fun! Spending some time with your child immediately after the patch has been put on and playing fun games can help make the transition easier. This is because the brain takes approximately minutes to adjust to having the dominant eye covered. Try to spend as much one on one time with your child as possible whilst they are wearing the patch. This will help take their mind off the patch itself, and furthermore they will really appreciate the time you spend with them. Try to find games and activities that capture your child s attention and make the affected eye work harder. If your child uses standard plain Opticlude patches then there is the option for them to decorate them using the free rub offs provided or by ing the Opticlude team at co.uk and visiting the Contact Us page. If you would prefer predesigned patches with funky fruit and perilous pirate designs then why not try Opticlude Boys and Girls patches!

7 Fun & Games for Everyone! For patching to be fun yet still achieve the desired results, your child s weak eye has to be made to work harder while the normal eye is patched. Games and activities that require visual acuity and hand-eye coordination work well. Start with simple activities. At first, your child s coordination may not be good because the brain is still learning how to use the weaker eye. Easy activities will help build your child s confidence and willingness to wear the patch. Joe & Rosie s Top Ten Activities! 1 Patching Parties 2 Jigsaw Puzzles 3 Pasta playtime. Put a large container of pasta in the kitchen for your child to play with whilst you cook. (Better for children over 3 years) 4 Catch (throwing or rolling) a ball 5 BUBBLES 6 Colouring in pictures. (You can use your own or download many variations at These can then be stuck into a scrapbook 7 Reading (picture books) and talking about the book/pictures 8 Games Page. (There are many fun games on here that build hand eye coordination) 9 Pin the Opticlude tail on the parrot 10 Playing on age appropriate video games

8 If you require any further assistance or information please either visit our website, or talk to your local orthoptist for details. Keep Patching. Good Luck from the Opticlude team!

9 Ordering Information Orthoptist Ordering Information Available to order from Bunzl Health Care. Product Name Order Code Size Order Units 3M TM Opticlude TM Junior NM x 6.0 cm 20 patches Orthoptic Eye Patch 3M TM Opticlude TM Standard NM x 8.0 cm 20 patches Orthoptic Eye Patch 3M TM Opticlude TM Boys and NM2537PE 5.0 x 6.0 cm 30 patches Girls Junior Orthoptic Eye Patch 3M TM Opticlude TM Boys and NM2539PE 5.7 x 8.0 cm 30 patches Girls Standard Orthoptic Eye Patch Tel manchester.healthcare@bunzl.co.uk

10 Parent Ordering Information Available to order from and now available from Please visit these websites for further information. References: 1. Amblyopia. J M Holmes, M P Clark. The Lancet, Vol 367, Pages , 22 April Amblyopia: Diagnostic and Therapeutic Options: Carolyn Wu & David G. Hunter American Journal of Ophthalmology Vol 141 Issue 1 January. 3. Clarke M, Richardson S, Hrisos S, et al. The UK amblyopia treatment trial: visual acuity and stereoacuity values in treated and untreated unilateral straight eyed amblyopia. In: de Faber J-T, ed. 9th meeting of the International Strabismological Association. Sydney, Australia: Swets & Zeitlinger, 2003:

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12 3 3M Health Care Limited 3M House, Morley Street Loughborough Leicestershire LE11 1EP Tel: Fax: M Ireland The Iveagh Building, The Park, Carrickmines, Dublin 18 (01) Fax (01) M, Opticlude and Cavilon are trademarks of the 3M Company. 3M GH242