Patching

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An Alternative to Patching

If one eye is weaker than the other, such as in the case of a lazy eye, one method that is used to train the brain to work with both eyes in an optimal manner is patching. This means the stronger eye is closed with a patch, forcing the brain to learn to work with the weaker eye. This method presents advantages and disadvantages. The main challenge with this approach is the fact that we shut down the functionality of the stronger eye for a period of time with the goal of strengthening the weaker eye. This could compromise the stronger eye since it doesn’t get used for some time. Once we stop using the patch, then the brain needs to relearn how to use both eyes together simultaneously which could present a challenge.

 

Monocular Fixation in a Binocular Field

There is a wonderful alternative to patching and that is monocular fixation in a binocular field, in short MFBF. This allows both eyes to be open while training and strengthening only one eye at a time, avoiding the need to shut one eye off. In order to achieve the MFBF effect, filters are used. For example, during a vision therapy session, a child is given the task of completing a maze on a paper by tracing the right path to the way out using a red marker. In that case, we would place a green filter in front of the lazy eye or weaker eye that we are working to strengthen. Since there’s a green filter in front of the eye, this specific eye is still able to view the target and perform the task of completing the maze. The other stronger eye which does not require training at the moment, is open however there is a red filter placed on top which prevents this eye from seeing the target. It means that both eyes are open but the weaker eye must meet the challenge to complete the task all on its own. By keeping both eyes open but using filters, we can control which eye is receiving the strength training and which visual signals the brain is able to perceive.

Monocular Fixation in a Binocular Field

Common Questions

Yes, there is an alternative to closing one eye with a patch for a period of time. The alternative method allows both eyes to stay open while using filters to control which eye is actively being trained. This avoids the challenges that come with keeping one eye shut for a period of time. Using filters to strengthen the weaker eye while the stronger eye is open but not participating in the activit, is called monocular fixation in a binocular field.
MFBF stands for monocular fixation in a binocular field. This means that one eye is being trained to properly fixate while the other eye is open but not participating in the activity. This provides many advantages as it enables one eye to be trained at a time, without the need to completely shut off the alternate eye. The other eye can remain opened but using filters it is separated so that it won’t interfere with the training of the eye that is currently being strengthened.
Patching
Dr. Wernick cartoon

Summary

There are various methods available nowadays which allow one eye to participate in a vision therapy activity at a time. Patching closes off the stronger eye, forcing the brain to learn how to work properly with the weaker eye. The alternative method of MFBF employs filters to keep both eyes open but to enable the focus to be on one eye at a time.

Testimonials


  • Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


    Mary K.

  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Peter G.

  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Kinkie F.

  • I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


    Allen B.

  • As a long time patient and grateful recipient of Dr Kavner's care for my whole family I can wholeheartedly tell others his care is exemplary. His knowledge base is thrilling, and how ability to synthesize his wisdom into useful, accessible information is comforting, to say the least. I cannot say enough about this kind, gentle man and his legendary skills - he was one of the fathers of Occupational Optometry.

     


    Alicia C.

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