How to get a 4 yr old to wear a patch

May 11, 2006 1:46 PM

My 4 yr old has recently been put on an eye patch to make his back eye strong. He won't wear it! What do I do? I have tried everything.

He has a bad eye and with the good eye covered he can't see past 5 feet. He has to wear a patch over his good eye so the muscle with get strong the bad eye, but I can't get him to wear it. He looks over it and pulls it down and that is doing no good at all. I have told him he can't watch TV without the patch or play on the computer or play his gameboy.but in return i get " i don't want to play it anyway."

posted by Tiffanyfinch2003 to human relations (45 comments total)

Get him excited about pirates? Rent Pirates of the Caribbean, buy some colorful and interesting pirate books, get a cool hat and Jolly Roger flag to go with it.

I dunno. Sounds cheesy, but it might work.
posted by aladfar at 1:48 PM on May 11, 2006

Pirate Supply Store
posted by xod at 1:50 PM on May 11, 2006

I agree. Pirate-mania was the first thing I thought of.

What if you went pirate, too?
posted by COBRA! at 1:50 PM on May 11, 2006

I suspect you may have to resort to bribery rewarding him. Is there something he really wants—maybe a game for his Gameboy, or a toy, or a trip somewhere, or his favorite dessert?

Tell him that, if he can wear the patch when he's supposed to, the way he's supposed to, for five days in a row, he can have something special. Then, when he completes each day, mark it off on the calendar. If he lapses, tell him he has to start over again on the five days the next day. Stick to it.

Once he does it for five days, do it again for seven. You don't say how long he's supposed to wear it, but I'd think eventually he'd get used to it.
posted by cerebus19 at 1:57 PM on May 11, 2006

Give him a choice of cool stickers to put on it? Batman, spider man, etc?

I second the idea about the pirate movies... Peter Pan (Captain Hook)??

Maybe get him one of those fake hook hands for him to wear? A pirate costume??
posted by kdern at 1:57 PM on May 11, 2006

My sister had to wear a patch in the Seventies for her lazy eye. She was school-age and had to suffer through many awful pirate jokes. Bad for her but I think a little boy could be persuaded that pirates are cool. I know I get a kick out of Jack Sparrow!

My parents finally resorted to a medical bandage patch after too many days of her turning the black pirate patch up or taking it off when she wanted. The adhesive wouldn't restick so they always knew if she had tried to cheat the eye patch. Everything worked and decades later you can't tell she ever had a lazy eye.
posted by moru71 at 1:59 PM on May 11, 2006

Two words: duct tape.
posted by gottabefunky at 2:00 PM on May 11, 2006

I had to wear a patch when I was 5 or so for the same reason, and if either of my parents had suggested pirates or used a pirate motif in any way, I would have run away from home. Just sayin'. I was acutely embarrassed about wearing it, and kids made fun of it constantly (no doubt because they could sense my embarassment). Have you talked to him about why it's important to wear it (not an accusation, just a clarification question)? Is it embarassment that makes him not use it, or that using the bad eye is too hard? I hated wearing it, but I hated having a weak eye more - I knew that's what it was for, and that helped a bit. Do you have any stories about having to do something similar that you could relate to him? Maybe offer to do some strength exercises (reading, whatever) with him to help him?
posted by Cyrie at 2:01 PM on May 11, 2006

Seconding gottabefunky.

In all seriousness, reasoning ("It's good for you") + discipline ("Because I said so") won't work?
posted by docgonzo at 2:04 PM on May 11, 2006

Aaargh, maties -- exactly what I thought. Make it cool to wear a patch!
posted by ericb at 2:13 PM on May 11, 2006

Consider the following: When we have to get our dog to take her medicine we usually hide it in some peanut butter.
posted by cloeburner at 2:13 PM on May 11, 2006

Second the medical bandage; I had to go through the same thing as your son. I hated it. I cried. I screamed. I raged. I made my mom feel like shit. She forced me to wear it anyway... and thanks to her, I didn't end up blind in one eye. Yay, moms!

Sometimes when you are a parent you gotta be the bad guy. A medical bandage patch with adhesive REALLY SUCKS but it sucks far less than losing vision in your bad eye.
posted by Justinian at 2:13 PM on May 11, 2006

An eyeball sticker over the patch?

I tried to find gross ones oozing slime and eyeball guts, but was not successful in a cursory search. :-(
posted by SuperSquirrel at 2:19 PM on May 11, 2006

I didn't have to wear the patch to school, but I was allowed to watch as much TV as I wanted, as long as I was wearing the patch. No patch = no TV.

With my daughter, earning "screentime" is a huge reward -- computer, GameBoy, TV, DVDs, etc. It's the first thing we take away to punish and the first thing we up to reward her.

(Of course, I only use one eye now because I snuck the eye patch off and watched Moonlighting with my good eye). To be fair, my aunt just used a maxipad taped on the inside of my glasses and I was old enough to be embarassed, so I'd recommend not doing that.)
posted by Gucky at 2:31 PM on May 11, 2006

So lately we (my wife and I) have been reading "How to raise your kids without raising your voice". Not that I think you're yelling at your son.

Anyway, I go with those who say tape it on. He'll never agree. Ever. Which doesn't make him a bad kid. But this particular book offers what's been a good strategy for us: if our child has to do something, we explain it, but then that's it. If there's no question, there's no discussion. Just tell him that's the way it is. If there are options, we can discuss things. But if there's no option (i.e. "I don't feel like going to school today"), there's no discussion.

On the more positive side, a mild bribe might work. How long does he have to wear it for? Give him a point a day and then at 5 or 10 or however many points he gets "a prize". Some people don't like this approach as they think it sets a bad precedent (paying for good behavior) however I'd counterpoint that every person who works in sales operates this way and no one mocks them for being paid on commission. Our son likes those lego sets that cost about $5-$10, which is a reasonable reward. For a 4-year old, maybe not lego. Maybe an ice cream cone out of the house, whatever. But you need to mention it briefly every day to help keep him on track.

Good luck getting through this!
posted by GuyZero at 2:31 PM on May 11, 2006

I wore one as a 4 year old.

My folks did the pirate thing and taped it.
posted by k8t at 2:35 PM on May 11, 2006

Deh, I got so excited I somehow missed the TV/gameboy part of the question. Sorry.
posted by Gucky at 2:44 PM on May 11, 2006

"Consider the following: When we have to get our dog to take her medicine we usually hide it in some peanut butter."

So they should smear the patch with peanut butter?

I, too, immediatly thought "pirates are RAD!" Maybe go the adhesive route, then draw a Jolly Rodger and patch on it?
posted by klangklangston at 2:50 PM on May 11, 2006

For our child, the eye doctor prescribed eye drops instead of a patch. The drops go in the good eye, dilates & blurs the vision, makes the lazy eye "work harder." His opinion was that it was much easier than trying to deal with a patch and there was no "cheating." The only drawbacks were a brief struggle with drops and having to wear sunglasses in bright sunlight.
posted by scubbadubba at 2:52 PM on May 11, 2006

I wore one as a child and here's the thing. It actually made my bad eye ache. I obviously couldn't see as well (in fact, much much worse) and all the kids teased me. So he has very good reasons not to wear it.

So, elastoplast. cut one circle smaller than the other and put the sticky bits together. Leaves you with a kind of a bandaid (that eyelashes shouldn't stick to. Do be aware that even little eyebrows hurt coming off and try to take this into consideration. (okay, they do make sticky eyepatches that shouldn't remove hair. They're fleshcoloured, so it looks (if you haven't got perfect vision) like your child was born with one eye only. Probably can pick them up from the chemist/pharmacist.)

Is this still the best optometrists can come up with? My daughter had to wear a patch and it reduced her sight so much that she accidentally hit her on the edge of the bed and needed stitches.
posted by b33j at 2:53 PM on May 11, 2006

Hit her head, i mean. Head.
posted by b33j at 2:54 PM on May 11, 2006

I was to have worn a patch when I was four. Now, at 36, I have a lazy eye which takes constant effort to keep under control. I was a very bright kid, and understood to the best of my ability the consequences of not wearing the patch.

I suspect that only bribery will work. That's the only thing that might have worked for me.
posted by solid-one-love at 2:55 PM on May 11, 2006

I had to wear a patch when I was 5 or so for the same reason, and if either of my parents had suggested pirates or used a pirate motif in any way, I would have run away from home thought that was the coooest idea ever. Just sayin'.
posted by fixedgear at 2:56 PM on May 11, 2006

I had to wear an eyepatch as a child, and as I recall I really didn't get behind it until I was given some paint and painted a skull and crossbones on it. Then I felt kinda cool about it. I think the intimidation factor might have helped allowing me to psyche out the other kids.

So yeah, cool stickers might do the trick.
posted by gallois at 2:57 PM on May 11, 2006

Thanks alot for all of the comments. To answer some of the questions: Yes I have explained to him the reason he has to wear his patch. No it's not embarassment because he doesn't wear it in public and his cousin also has to wear one. No reasoning and discipline doesn't always work. I have tried everything just for the simple fact that patches are expensive and to have a crying child who has to have a new one put on every 10 minutes because that one is wet.
posted by Tiffanyfinch2003 at 3:03 PM on May 11, 2006

I had to wear a patch for 5 years and it did nothing. I'm still blind in one eye and my dr was a fucktard. I was constantly ridiculed and had to sit in the front of the class, everyday while everyone threw stuff at me and called me "one eyed willy". Good for your kid, he knows what's best
posted by killyb at 3:32 PM on May 11, 2006

One more, not very good idea, to be used as a last resort:

If bribery, glue, and pirates don't work, block out a few days to play Big Brother. That is, have a few days where you have nothing else to get done but focus on this. Then, for those days, do not let him out of your sight, ever. If he's pulling the patch down in front of you, then have him sit in your lap for hours at a time with one hand holding down his arm.

When he complains, let him know why, and keep him there. Let him know that soon you'll try letting him be free again. Then, in a few hours, let him go. As soon as you see him touch the patch, it's back to in your lap for a few hours, even if it's just a minute after you let him up. It'll be bad, and there will be much unhappiness, but three year olds have more understanding of consequences than you might think. It might not work in a day, but I'd be surprised if he was not (very unhappily) wearing it after two.

Here's the problem: You have to make wearing the patch less bad than not wearing it. Wearing it sounds pretty bad from other people's descriptions. So you have to make not wearing it pretty darn awful. If the alternative weren't blindness, I wouldn't recommend this route.

But if your kid is the average stubborn three year old, and convincing him with bribes doesn't help, that's what I see working.
posted by kingjoeshmoe at 3:44 PM on May 11, 2006

Maybe if you wore an eyepatch? Maybe a double-bribe where you both get something if you both wear your eyepatches.
posted by Wood at 3:46 PM on May 11, 2006

God forbid he's figured out that crying will get him out of the patch. Kids that age rock at crocodile tears. Given your clarification, I'd recommend hard core bribery. But you'll have to be firm and not let him blackmail you for escalating levels of bribery, so you'll likely need to balance it out with a zero tolerance policy for whining.
posted by desuetude at 3:47 PM on May 11, 2006

Oh, agree with kingjoeshmoe, too. I don't envy you and how unpleasant this will be.

My mom has completely screwed-up depth perception due to an undiagnosed (um, really ignored more than undiagnosed) lazy eye. She's quite embarassed by how poor her vision is in the weak eye, and deep down she's still a little resentful that she couldn't even get her mom to take her vision complaints seriously. Kudos for doing what's best for your kid!
posted by desuetude at 3:55 PM on May 11, 2006

I don't know how successful this method really is (for all those poor people who missed out on it) because it taught me to see absolutely monocularly. Now I look through the good eye, and the bad eye is just for peripheral vision. If they hadn't forced separate vision on me as a small child, who knows? (I think a hole in the eyepatch would actually make it more effective).

Secondly, depth perception only really counts in the first 15 feet or so (someone blind in one eye recently told me). Past that, everyone relies on other cues, like objects in front of each other.

One of the reasons I suggested elastoplast is because it is so damn difficult to take off. If you are determined to go this way (and I too followed doctor's recommendation and followed up with eye surgery for my daughter to strengthen her muscles), then a patch that a child cannot remove is going to be more successful. Once they experience the removal, you can tell them, okay, if you want to have the other patch which hurts less, you have to keep it on. I would rather use that patch on you, but you've been doing x to it, and so I have to use this one. Which is it going to be?

(I very much doubt the efficacy of this treatment - i wonder if they have studied the results of it recently, or are still just going on the basis of what someone 50 years ago thought would be a good thing.)
posted by b33j at 4:10 PM on May 11, 2006

I second the drops idea. I had them when I was 2 - 5 - so 3 years, several times a day. It worked pretty well. I'd never have worn the patch. The drops don't give you an option.
posted by clarkstonian at 4:14 PM on May 11, 2006

Going along with SuperSquirrel's eyeball sticker idea, I'd get a handful of the pirate-style patches, then paint them with a variety of cool/creepy/weird-looking eyeballs. ("So what do you want to wear today, the bloody eye, tiger eye, or flaming angry demon eye?")
posted by Vervain at 4:38 PM on May 11, 2006 [1 favorite]

Ok, I'm just pissing in the wind here, because I think for a 4 year old the pirate thing is awesome - particularly this summer since Pirates of the Caribbean #2 comes out this summer and our 9 year old couldn't be more excited. If it will help you any, there's all kinds of stuff already making all the kid's wish lists here.

I also like the sticker idea, it's a way to keep the kid actively captivated with the idea.
posted by eatdonuts at 5:12 PM on May 11, 2006

I scratched my cornea in 1st grade and had to wear a patch for a few weeks - I was into it all on my own, because I loved pirates (and this is pre-"Jack Sparrow", mind you).
posted by sluggo at 5:16 PM on May 11, 2006

I had to wear one when I was six, right around my first day of school. To help it seem cooler, my mom drew a little picture on it every morning that matched my outfit - my favourite picture of myself as a child is me standing on the porch, in a little sundress with sailboats around the bottom, an eyepatch with a matching sailboat, and the biggest grin I've ever seen.

I remember the five minutes my mom took every morning to ask me what I wanted on my patch, then to talk to me about whatever I wanted while she sat in the kitchen and decorated the patch. I missed it when I didn't have to wear the patch anymore.
posted by deadtrouble at 5:37 PM on May 11, 2006 [1 favorite]

I wore one when I was 10 due to double vision (which surgery later helped to correct, but before then it was really bothersome) and decorated my patches with stickers. I loved it. Granted, I don't know if I'd have liked the idea as much if I had been a boy, but when you're 4, anything goes.
posted by hopeless romantique at 6:17 PM on May 11, 2006

A little late, but I would like to know what he says when you ask him what bothers him about it. Is it painful, or what? Knowing that answer can help you figure out the best tactic to take. (Avoid asking "why" he won't wear it--why questions aren't very clarifying, expecially with such a young 'un, but ask him what about it is pesky.)

And add me to the "pirates are cool" faction.
posted by thebrokedown at 6:57 PM on May 11, 2006

Could you buy him a really cool pair of sunglasses tinted enough so that no one else can tell that you've blocked off the side with the good eye? He could wear them outside and so long as no one bugs him to let them try the glasses on, no one will know what's going on.

But I mean really cool. No skimping. Oakley or something.
posted by krisjohn at 8:42 PM on May 11, 2006

I was wondering, maybe you could wear an eyepatch (or something similar that you can see through) along with him, since he doesn't have to wear it in public. When our son was told by the doctor that he would have to wear glasses to bring out the vision in his weak eye, he flat out refused to (he was 6 at the time), because he thought they "made him look stupid" and that "nobody else in the family wears them." So I quit using my contact lenses and got myself the coolest pair of glasses that I could find and started wearing them, all the while bragging to him that I looked so smart and great. Eventually, he agreed to wear them, so long as he wasn't the only one in the family with glasses. I still sometimes have to tell him he looks super cool in them. (Problem is, now he won't let me go back to my contact lenses...)
posted by misozaki at 10:35 PM on May 11, 2006

Pirate stuff and stickers are fun but if he can't see himself in the mirror to enjoy them, then they probably won't make such a good motivator.

Is it possible that his vision in the bad eye is worse than everyone thinks? I went through this around your boy's age and was miserable not because of discipline or embarassment issues but because I truly couldn't see. I remember being told that these "eye exercises" were for my own good and I did as I was told, but wearing the patch was almost as bad as wearing a blindfold.

Rather than leaving him to his own devices in front of the TV (which he probably can't see very well anyway), maybe you can make eyepatch time = fun family activity time. Help him pass the time wearing the tortuous thing by playing a board game or card game with him. It would help with hand-eye coordination, focusing, etc, and show him that you love him (i.e. are not punishing him with the whole eyepatch thing). You can wear one too. I wish my parents had done this.
posted by QueSeraSera at 11:45 PM on May 11, 2006

If all else fails there's always good old fashioned fear! "If you don't do this you'll be blind when you're older and you won't be able to see anything!"
posted by wackybrit at 2:59 AM on May 12, 2006

I've heard that the biggest motivator for kids is time with their parents. The notion of holding the kid down as punishment/control is antithetical to this.

Perhaps simple time-out for patch removal, and the reward of attention/time with Mom for keeping it on, will do the trick real quick.

Alternatively, put some control mits on him so he can't do anything that requires his hands, such as remove the patch. This is a sort of time-out. Reward for keeping it on, or the mits for taking it off. Such mits are used in hospitals to keep kids from digging at wounds and that sort of thing.
posted by Goofyy at 3:02 AM on May 12, 2006

Lost the long answer in a crash, but how about bandannas? Tie it in the back and drape it over one eye. They're dirt cheap, absorbent, washable, reusable, and come in some amazing colors. If it feels stiff, throw a cotton ball under it until it's been washed a few times.
posted by unrepentanthippie at 6:10 AM on May 12, 2006

I had to wear one when I was his age. I had the adhesive kind, to stop me from just taking it off. My mom drew pictures on them every morning, which I liked. (Once my sister drew an eye on it, and I refused to wear it.)
posted by The corpse in the library at 1:47 PM on May 14, 2006