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The Pinch Patch Technique
Volume 18 Number 5 / October 2014 10. Bar-Sela SM, Spierer A. Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery. Eye (Lond) 2006;20:1044-8. 11. Gupta A, Ramappa M, Kekunnaya R, et al. Comparing the astigmatic outcome after paediatric cataract surgery with different incisions. Br J Ophthalmol 2012;96:386-9. 12. Safir A, Hyams L, Philpot J, Jagerman LS. Studies in refraction. I. The precision of retinoscopy. Arch Ophthalmol 1970;84:49-61. 13. Hyams L, Safir A, Philpot J. Studies in refraction. II. Bias and accuracy of retinoscopy. Arch Ophthalmol 1971;85:33-41.
Wall et al
14. Lambert SR, Buckley EG, Drews-Botsch C, et al. Infant Aphakia Treatment Study Group. The infant aphakia treatment study: design and clinical measures at enrollment. Arch Ophthalmol 2010;128:21-7. 15. Wang X, McCulley JP, Bowman RW, Cavanagh HD. Time to resolution of contact lens-induced corneal warpage prior to refractive surgery. CLAO J 2002;28:169-71. 16. Russell B, Ward MA, Lynn M, Dubois L, Lambert SR. Infant Aphakia Treatment Study Group. The infant aphakia treatment study contact lens experience: one-year outcomes. Eye Contact Lens 2012;38: 234-9.
The Pinch Patch Technique Although compliance with patching can improve vision over time, patching can pose a challenge to examiners and parents of amblyopic children. What do you do when a parent has given up and refuses to continue patching? We use a simple technique that reduces the discomfort of having a patch over the eye. Adhesive patches are flat and when placed over the eye the patch either force the lids closed or, worse, cause lashes to rub on the ocular surface (Figure, left). Use the pinch patch technique, a simple manipulation of the patch adhesive to make the patch convex over the eye (Figure, right). Pinching the middle upper and lower areas on the patch before adhering over the eye will cause the patch to vault over the eye, reducing discomfort. This can also be very useful during a visual field examination by reducing squinting. Both eyes open during the visual field is better for testing and eliminating false defects. This technique may lead to better results and happier patients. —Candice Lee Gardemal, COA, Texas Children’s Hospital, Houston
Journal of AAPOS
445
Wall et al
14. Lambert SR, Buckley EG, Drews-Botsch C, et al. Infant Aphakia Treatment Study Group. The infant aphakia treatment study: design and clinical measures at enrollment. Arch Ophthalmol 2010;128:21-7. 15. Wang X, McCulley JP, Bowman RW, Cavanagh HD. Time to resolution of contact lens-induced corneal warpage prior to refractive surgery. CLAO J 2002;28:169-71. 16. Russell B, Ward MA, Lynn M, Dubois L, Lambert SR. Infant Aphakia Treatment Study Group. The infant aphakia treatment study contact lens experience: one-year outcomes. Eye Contact Lens 2012;38: 234-9.
The Pinch Patch Technique Although compliance with patching can improve vision over time, patching can pose a challenge to examiners and parents of amblyopic children. What do you do when a parent has given up and refuses to continue patching? We use a simple technique that reduces the discomfort of having a patch over the eye. Adhesive patches are flat and when placed over the eye the patch either force the lids closed or, worse, cause lashes to rub on the ocular surface (Figure, left). Use the pinch patch technique, a simple manipulation of the patch adhesive to make the patch convex over the eye (Figure, right). Pinching the middle upper and lower areas on the patch before adhering over the eye will cause the patch to vault over the eye, reducing discomfort. This can also be very useful during a visual field examination by reducing squinting. Both eyes open during the visual field is better for testing and eliminating false defects. This technique may lead to better results and happier patients. —Candice Lee Gardemal, COA, Texas Children’s Hospital, Houston
Journal of AAPOS
445