Translucent Cling Patching: Diplopia Management
When possible, therapies that do not require patching are advised. However, some patients have double vision that is resistant to treatment. Semi-translucent spot, sector press-on patches and/or the new mirror/occlusion eyewear can be used to block only that position of the gaze causing the diplopia. These are particularly helpful for patients who have sudden intermittent diplopia in certain areas of gaze. These are well received by patients and reduce the cosmetic and functional problems caused by the traditional black patch.
The traditional black patch should no longer be the only option offered patients with periods of intractable diplopia. The black "pirate" patch is obviously very poor cosmetically, but also is poor psychologically for a patient faced with an uncertain time ahead with diplopia. The blockage of light from the eye is also uncomfortable for most patients. A simple solution we use at our centers is to apply a translucent patching material which originally invented to reduce vision in the patched eyes of amblyopic children. It allows some light and motion to reach the eye, but adequately blocks the double vision in most situations.
Notice the improvement of the appearance of this young lady with a traumatic third nerve paralysis. Note the top right picture which shows the right eye drifting out and down. At ten to twenty feet, the patch is nearly invisible to others. Patients feel better about appearing in public.
Here we applied a translucent patching material to the right lens of her eyewear. It can be applied in minutes, often to the existing eyewear. Here we have applied the patch to the the entire lens. In some cases with specific areas of gaze in which double vision occurs, it may be possible to patch only a sector or spot. See our section on sector and spot patching.
Notice that while some vision may pass through the patch, the awareness of the image is greatly reduced. We have profoundly reduced the contrast of the image so that diplopia is rarely noted. At night bright lights may appear doubled since they can penetrate the material. At night we simply add a clip-on occluder.
To further hide the patching material in sun wear or "travel" eyewear (shopping, travel, driving in daytime), we can apply a mirror coating to hide the patching material completely.