Optometry & Visual Performance 238 Volume 13 | Issue 4 | December 2025 Article • The Success of Patching Therapy in An Infant Population at Rehabilitative Kindergartens/Nursery schools Kenneth Koslowe OD, MS • Eliya, The Association for Blind and Visually Handicapped Children Petach Tikva, Israel Introduction The use of patching one eye as a treatment for or prevention of amblyopia in infants and children has a long history.1-3 While there continues to be a debate about the hours patched and whether this is the best treatment protocol, it is still widely accepted.4-12 One basic measure of the success of the treatment is the change in visual acuity. While here also there are differences of opinion of whether this is the best measure of “success,” it continues to be the standard measurement of treatment.13 The basic theory behind the use of patching is not to “strengthen the weak eye,” but to improve the communication between the eye and the visual cortex. As such, in most cases, patching is instituted after correcting pathological and optical causes for poor vision. In some cases, patching has been used without correcting such defects, although the reasoning behind this seems to be much weaker. Eliya is a non-profit organization under Government supervision, with a network of five rehabilitative nursery school/kindergarten frameworks. Our purpose is visual rehabilitation and training for infants who are blind or visually impaired. In Israel, this also includes children who are visually impaired in one eye, even if this is due to recommended patching. The early intervention programs and professional services foster the full potential of children who are visually impaired or blind. Adopting a holistic approach, Eliya nurtures children’s visual, emotional, social, and intellectual skills. Learning happens best in a sensoryKenneth Koslowe, OD, MS Petach Tikva, Israel BS, Yeshiva University, 1969 OD, PCO, 1974 Residency in VT, SUNY MS (Psychology), Ferkauf Graduate School Founding faculty member, Hadassah College of Optometry and Bar Ilan University School of Optometry ABSTRACT Purpose: Patching has long been an accepted treatment method in treating or preventing amblyopia and strabismus, particularly in infants. Eliya is a non-profit network of rehabilitative kindergartens/nursery schools for the blind or partially sighted in Israel. As many of our children are accepted with recommendations for patching, it was felt that it would be useful both for our staff and the referring doctors to monitor the results of the recommended patching regimen. Methods: An initial group of 29 was identified by the referring documents as having patching recommended. They were located in four out of our five centers throughout the country. In each center, a staff member underwent training by the primary author (an optometrist with 50 years of experience) until they were proficient. The test chosen for monitoring was the Lea Paddle Acuity test. This was both available, easily trainable, and successful. All infants with a recommendation for patching were included in this project; no preselection was done regarding diagnosis or the amount of patching that was recommended. From the initial group of 29, nine children dropped out either due to total non-compliance with patching or a change in the recommendation of the referring doctor. The twenty remaining children consisted of 14 post-cataract surgery (average age at time of surgery was 6.8 weeks) and six with varying retinal problems. They were tested every three to four months for a final testing period of approximately one year from the start of the study Results: At the end of one year, 12 of the 14 postcataract children showed marked improvement or had normal acuity in the affected eye, while only one of the retinal cases showed any improvement. Conclusions: Patching one eye produced satisfactory results in cases of post-surgical monocular cataracts. It was largely ineffective in cases of retinal defects, especially so as the defects themselves were not resolved prior to the treatment. Keywords: amblyopia, infants, patching
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