Entertaining a One-Eyed 7-Year-Old
February 20, 2004 6:17 PM   Subscribe

On Monday I have to cover my seven year old daughters left eye with a patch for eight weeks. The idea is to strengthen her right eye -- currently 20/300 -- in the advent that later in life she should damage her good one. Insurance, so to speak. Any thoughts on making life more palatable for a temporarily blind child ?
posted by cedar to Human Relations (20 answers total)
My nephew went through this. He clung to his mother for a few days - he was only six - but he seemed to adjust pretty quickly. I don't think they took any special measures for him. Although in his case he only had to wear it a certain number of hours a day.

You've probably already done this, but it would be a good idea to speak to her teacher and suggest that her desk be moved to the front of the class to make it easier for her to see the blackboard.
posted by orange swan at 6:52 PM on February 20, 2004

They tried to get me to do this. I'd peel the patch off waiting for the school bus and stick it to the street pole, where my mom would spot it later in the day...

The end result is, I see out of my right eye for vusual accuity, use my left for depth perception and peripheral vision, and have no deficits compared to a person who sees equally out of both eyes.

I seem to rrecall that this treatment, designed to force the brain to build more neural connections to the eye thats seeing less than the good eye, as never really been proven to work significantly. This is because the the problem which causes the brain's visual cortex to favor the better eye, is located in the weaker eye and the treatment does nothing to address the problem...

The brain is well known for its plasticity and if the worst case scenario were to happen in the absence of the dreaded eye patch (which has the potential for all sorts of socialization side fx) the brain will adapt at any age, not just in childhood...

Of course, I am not an apthamologist/neuroligist etc. I'm just sying I forewent the treatment ann it hasn't held me back in any way.
posted by Fupped Duck at 7:52 PM on February 20, 2004

Fersure. I am (was) 20/200 in my left eye (legally blind) and 20/10 in my right eye (eagle-eyed).

When I was a kid/teen, my left eye got next to no use: too poor to use even for close-up reading. It did make near things blurry, though, so it'd cross-over. It's picture would then be so "off" from the right eye's picture that my brain would ignore it.

As I've gotten older my left vision has improved; no idea if my right vision is getting worse. These days I tend to read with my left eye and see distance with my right, with little interaction between them. Far less crossed-eye stuff, although also because I've learned to close my left eye.

The one time I tried a contact lense, it was mind-blowing. Stereoscopic vision is pretty damn cool!

But stereoscopic vision only applies to close-range things, less than six feet away. After that your brain doesn't rely on the difference between pictures to interpret 3D: it uses parallax, size relations, detail level, etc.

In the end, I've never found it worth bothering with a contact lense. (Glasses wouldn't work; the difference between lenses would look bizarre, and the balance would be off.)
posted by five fresh fish at 8:04 PM on February 20, 2004

Response by poster: In the interests of saving space, I'll throw in a self link to my weblog where I explain the situation in more detail.

orange swan: Sitting closer isn't going to do it. She will be seeing out of one 20/300 eye -- she could literally sit at arms length from the blackboard and not be able to make it out. For all practical purposes she will be blind (she'll get light and dark, big blotches of color, she'll know when someone walks into the room but she won't know who it is). I should mention that this is a rural school with six children and two teachers, even if I had the luxury of time it's unlikely they could provide the necessary services. I'll probably be home schooling for the next couple of months, fortunately there is a two week break in there.

fupped duck: In this case she will always be blind out of that eye -- I understand that this is not a major handicap and she'll manage just fine. Hell, we didn't even know she couldn't see out of it until a week or so ago and she is doing wonderfully in school and is a fantastic athelete (the worst part is she'll miss the end of ski season).

I know this is a bit much for Askmefi responses, but I'm a little tweaked about this whole thing and haven't had a chance to research it any depth.
posted by cedar at 8:21 PM on February 20, 2004

For all practical purposes she will be blind (she'll get light and dark, big blotches of color, she'll know when someone walks into the room but she won't know who it is)

It won't be like being blind; it'll be like looking through out of focus binoculars. My vision in each eye is in the neighborhood of 20/600. Without contacts or glasses, I can navigate the house just fine, I can grab little things here and there, all that jazz. I just can't focus more than about 2 feet away. But yeah, she'll have trouble reading the board from any of the seats.

One thing to think about with your daughter's bad eye is getting her into rigid contact lenses as soon as she's mature enough to manage them (and assuming her eye will tolerate them). I got RGP lenses when I was about 17, and I went from having to get a more powerful prescription every year (or more often) to not having my prescription worsen in 18 years. Instantly. The rigid lenses help stop your eyes from getting even wonkier, or something. Talk to the eye people about it, anyway, it can't hurt nuthin' to talk.
posted by ROU_Xenophobe at 9:39 PM on February 20, 2004

I would think that to distract her from her temporary blindness, an ipod or other such device would work. Music, of course, but I'd also suggest audio books as an alternative.
posted by o2b at 9:47 PM on February 20, 2004

Maybe "decorate" the patch -- the way that Band-Aids now come in different styles, like SpongeBob and superheroes and such...? Make wearing the patch look cool.

Good luck.
posted by davidmsc at 10:04 PM on February 20, 2004

Why does the doctor want to do this now instead of waiting for summer vacation? Seems like it's something that could easily wait a few months, and waiting wouldn't affect her studies nearly as much, nor would she miss the end of ski season.
posted by kindall at 10:05 PM on February 20, 2004

Response by poster: ROU: Thanks, that's reassuring. It wasn't the impression I was given by the doctor, but for some odd reason I find your personal expierience more credible. God, I love this place.

kindall: This is something that is normally done at 4-5 years of age with a 70% chance of success. It falls off rapidly from there and right now we're at about 15%. I was told that sooner is better and months can make a difference. I don't know if this is true, but living in a rural area with other responsibilities a second opinion is a luxury. May as well get it over with. No skiing or no swimming, it's a toss up as far as I'm concerned. Her studies aren't a concern, this is a smart kid in second grade, we can handle the schoolwork verbally for twenty-five school days (of the 7-8 weeks she'll be patched two are spring break and there are a couple of long weekends).

What kills me is that this is likely for nothing, but as a father I gotta go for that 15% chance, the other option is 0% and that won't do at all.
posted by cedar at 10:23 PM on February 20, 2004

Tell her she's a pirate and give her a lot of safe room to stomp around in.

My brother had to do it for the same reasons (plus a lazy eye), and I think the pirate comments actually helped a lot. Nothing like imagining yourself as a bloodthirsty menace of the seas to make up for the fact that you can't exactly see what's going on.
posted by Katemonkey at 1:50 AM on February 21, 2004 [1 favorite]

This was done to me at around age four. Similar story. As a thirty something adult I now have better than average sight in one eye and the other is just about ok for noticing peripheral movement, ambient light levels and color. I've never considered it a disability and it never hindered me from doing sports, school work, or any other childhood or adult activities.

Fupped Duck's comment struck a chord. In my case, I became amazingly adept at seeing sideways through a corner of the patch over the good eye, which I'd peel back slightly when I thought no one was watching. How committed are you to the job of eye-patch policeman?

I'd also have to agree that I recall no noticeable improvement resulting from this treatment. Having said that, I'm not a doctor and no one here is there, so the obvious thing is to follow local advice. None of which answers the question, I'm afraid. The best I can suggest is keeping your daughter aware of where you or another responsible person is, in case of scary moments, and maybe offering some kind of occassional reward for persevering with it - all pretty obvious, I guess.
posted by normy at 4:19 AM on February 21, 2004

While I'm doubtful that it will help the eye, use this time to foster improved reliance on her sense of hearing. While my vision is slightly worse than 20/20 in both eyes, I consider my primary sense to be hearing. This means that I feel more out of touch with the world when I can't hear it than I do when I can't see it.

You might work with her on locating objects in a room through sound, and identifying people by the sound that they make when they walk. If nothing else it'll be a fun game to play. But increasing her general aural perception will benefit her greatly.
posted by woil at 4:27 AM on February 21, 2004

I had to do this when I was about eight years old.... My mother (bless her heart) went to the school, and had a talk to my teacher and the principal about what was happening, and told them to put up with my rather "unusual" dress for a few weeks.
Then she bought me a cool pirate hat, a way-cool sword, and drew a fresh tattoo on my arm every day before school. By the time the patch came off, I was fairly good at impersonating a pirate, let me tell you.
Surprisingly, my classmates had no problem with it at all, and it actually helped get me my first girlfriend. ( She liked the whole bad boy pirate look, I guess.)
posted by bradth27 at 7:16 AM on February 21, 2004

I, too, underwent this when I was seven. The reason was a little different and acuity-wise I was a little better off than 20/300 in the unpatched eye, but it was still partial blindness and still frustrating.

The worst part of it was the family outings. I remember a trip to the zoo that was infuriatingly awful: the day was mostly looking at things and was a constant reminder of the patch's presence. The good times were when I was able to forget I was wearing it, doing normal everyday things while still complying with the treatment. The best times were when the doc okayed me to take an occasional day off from the covering and be able to actually see for a while.

The second worst part was pure physical discomfort; I didn't have a comfortable patch that was fitted to my eye, I had a plastic piece that was gauzed inside and taped on. I don't know if there was a medical reason for this or if it came down to my stepmother being too wicked to get me a cool pirate-style patch with a strap, but the physical presence of the thing was really bothersome beyond the inconvenience of partial blindness.

The whole thing was, however, helped along by my folks preparing my stepbrother carefully to keep him from hassling me about it. Given that we fought like cats and dogs over every other thing, not having the eyepatch as a crippling disadvantage in that arena was helpful.

The moral of the story: Lay the groundwork to keep siblings off her back, be extra supportive and endlessly sympathetic to the misery she's feeling, and keep her out of situations where her partial blindness will prevent her from enjoying your activities, take pains to deal with the physical discomfort -- having stuff stuck to your face is just annoying -- and keep her distracted from it as much as possible.
posted by majick at 8:30 AM on February 21, 2004

My sister did the patch thing when she was about 4. Much, much better vision now. Her only complaint now is how ridiculous she looks in the pictures of her with the patch. Moral of the story: don't take too many pictures of the patch. She'll cringe later.
posted by katieinshoes at 9:08 AM on February 21, 2004

One big way that people with low vision cope with getting around is to rely very heavily on memory, where you last put something, what angle the dial on teh oven should be at for 250°, that kind of thing. Over time her general ability to move around in comfortable environments should improve dramatically to the point where you may _think_ her vision is improving even if it isn't really in any physical sense. (not that thi isn't a good thing anyway)

Her overall memory may also be helped just through the increased brain-exercising.

If she does things ilke makes her own cereal in the morning, let her keep doing them, and she'll get better at things like that with practice. Little tricks like putting your finger in a glass of water while it's filling up to tell when to stop help too.
posted by Space Coyote at 1:28 PM on February 21, 2004

One big way that people with low vision cope with getting around is to rely very heavily on memory, where you last put something, what angle the dial on teh oven should be at for 250°, that kind of thing.

I sincerely doubt she'd need to do anything like that with 20/300 vision. Everything's going to be there... just blurred (well, okay, very very blurred). About the only exceptions are very small objects and settings with very poor contrast (ie, a blue thing dropped on a blue tile), and objects that are clear.

She's not likely to stumble around trying to grab her toothbrush and failing (well, not from myopia; I suppose not having depth perception might do that). What she won't be able to do is tell the blue toothbrush with JENNY written on it from the otherwise identical blue toothbrush with BOBBY written on it, and she might mistake a short-head toothbrush for a medium-head toothbrush.
posted by ROU_Xenophobe at 2:25 PM on February 21, 2004

Response by poster: Thanks to everyone, this has been very useful.
posted by cedar at 3:17 PM on February 21, 2004

My situation is much like fff's: right eye excellent, left pretty much useless. A doctor told my parents when I was a kid to ignore suggestions to do something like this, that my brain would work it out and I'd be fine. Such has been the case. My glasses correct the left eye proportionately to the right (rather than trying to bring it up to 20/20), and I do well with both distance and close-up. Not trying to discourage you from following doctor's advice, just saying if she manages to evade the patch (as other nefarious posters seem to have done) it probably won't do her any harm. Good luck!
posted by languagehat at 3:18 PM on February 21, 2004

I also fall in this category, although probably not as bad as your daughter. (If I close my right eye, I have to set my 21" monitor at 640x480 and get about a foot from the screen to be able to read.) It has never been much of an issue, and although I was made to wear eyeglasses from about age 7 onwards, they never really helped improve my left eye, and after high school I stopped wearing them altogether. As other people have mentioned, my brain pretty much ignores what my left eye sees, unless it's seeing something that is blocked for my right eye. I am guessing that my depth perception isn't quite as good as it should be, but it's never been a problem.
posted by deadcowdan at 5:08 PM on February 21, 2004

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