Eyepatch

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Eyepatch
Child eyepatch.jpg
A child wearing an adhesive eyepatch to correct amblyopia

An eyepatch is a small patch that is worn in front of one eye. It may be a cloth patch attached around the head by an elastic band or by a string, an adhesive bandage, or a plastic device which is clipped to a pair of glasses. It is often worn by people to cover a lost, infected, or injured eye, but it also has a therapeutic use in children for the treatment of amblyopia. Eyepatches used to block light while sleeping are referred to as a sleep mask.

Contents

An eyepad or eye pad is a soft medical dressing that can be applied over an eye to protect it. It is not necessarily the same as an eyepatch. [1]

History

In the years before advanced medicine and surgery, eyepatches were common for people who had a lost or injured eye. They were particularly prevalent among members of dangerous occupations, such as soldiers and sailors who could lose an eye in battle. While stereotypically associated with pirates, there is no evidence to suggest the historical accuracy of eye patch wearing pirates before several popular novels of the 19th century (see Association with pirates below).

Medical uses

Amblyopia

Eye patching is used in the orthoptic management [2] of children at risk of lazy eye (amblyopia), especially strabismic or anisometropic [3] amblyopia. These conditions can cause visual suppression of areas of the dissimilar images [4] by the brain such as to avoid diplopia, resulting in a loss of visual acuity in the suppressed eye and in extreme cases in blindness in an otherwise functional eye. Patching the good eye forces the amblyopic eye to function, thereby causing vision in that eye to be retained. [2] [3] It is important to perform "near activities" (such as reading or handiwork) when patched, thereby exercising active, attentive vision. [5]

A study provided evidence that children treated for amblyopia with eye patching had lower self-perception of social acceptance. [6] To prevent a child from being socially marginalized by their peers due to wearing an eye patch, atropine eye drops may be used instead. This induces temporary blurring in the treated eye.

It has been pointed out that the penalization of one eye by means of patching or atropine drops does not provide the necessary conditions to develop or improve binocular vision. Recently, efforts have been made to propose alternative treatments of amblyopia that do allow for the improvement of binocular sight, for example, using binasal occlusion or partially frosted spectacles [4] in place of any eye patch, using alternating occlusion goggles or using methods of perceptual learning based on video games or virtual reality games for enhancing binocular vision.

A 2014 Cochrane Review sought to determine the effectiveness of occlusion treatment on patients with sensory deprivation amblyopia, however no trials were found eligible to be included in the review. [7] However, it is suggested that good outcomes from occlusion treatment for sensory deprivation amblyopia rely on compliance with the treatment.

Extraocular muscle palsy

To initially relieve double vision (diplopia) caused by an extra-ocular muscle palsy, an eye care professional may recommend using an eyepatch. This can help to relieve the dizziness, vertigo and nausea that are associated with this form of double vision. [8] [9] [10]

Use by aircraft pilots

Aircraft pilots used an eye patch, or close one eye to preserve night vision when there was disparity in the light intensity within or outside their aircraft, such as when flying at night over brightly lit cities, so that one eye could look out, and the other would be adjusted for the dim lighting of the cockpit to read unlit instruments and maps. [11] Some military pilots have worn a lead-lined or gold-lined eyepatch, to protect against blindness in both eyes, in the event of a nuclear blast or laser weapon attack. [12] [13] [14]

Eyepatches are not currently used by military personnel; modern technology has provided an array of other means to preserve and enhance night vision, including red-light and low-level white lights, and night vision devices. [15] [16] [17]

Association with pirates

1783 etching of wounded sailors Two sailors with amputated legs, an eyepatch and an amputate Wellcome V0020360.jpg
1783 etching of wounded sailors

Ex-sailors ashore sometimes wore an eye patch to cover the loss of an eye, but pirates rarely wore eye patches while aboard ships. There were some exceptions, including Rahmah ibn Jabir al-Jalahimah, a well-known pirate of the Persian Gulf, who wore an eye patch after losing an eye in battle. [18] [19]

Medical texts have referred to the eye patch as a "pirate's patch" and, writing in the Minnesota Academy of Sciences Journal in 1934, Charles Sheard of the Mayo foundation pointed out that by "wearing a patch (The pirate's patch) over one eye, it will keep the covered eye in a state of readiness and adaptation for night vision". [20] This technique was explored during WWII by institutes such as the United States Navy. [21] It has been suggested that pirates before electric lighting wore eyepatches to keep one eye adjusted to darkness ahead of a boarding operation, so that they would be ready to fight below deck where the lighting was poor. This idea was tested in an episode of MythBusters in 2007 and found to be plausible, but this application has never been documented in any historical naval manual. [22]

Notable wearers

In fiction

An eyepatch can be used in fiction to lend an additional dimension to a character, an air of mystery or general je ne sais quoi . [74]

See also

Related Research Articles

<span class="mw-page-title-main">Atropine</span> Anticholinergic medication used as antidote for nerve agent poisoning

Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically given intravenously or by injection into a muscle. Eye drops are also available which are used to treat uveitis and early amblyopia. The intravenous solution usually begins working within a minute and lasts half an hour to an hour. Large doses may be required to treat some poisonings.

<span class="mw-page-title-main">Esotropia</span> Form of strabismus in which the eyes turn inward

Esotropia is a form of strabismus in which one or both eyes turn inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is the opposite of exotropia and usually involves more severe axis deviation than esophoria. Esotropia is sometimes erroneously called "lazy eye", which describes the condition of amblyopia; a reduction in vision of one or both eyes that is not the result of any pathology of the eye and cannot be resolved by the use of corrective lenses. Amblyopia can, however, arise as a result of esotropia occurring in childhood: In order to relieve symptoms of diplopia or double vision, the child's brain will ignore or "suppress" the image from the esotropic eye, which when allowed to continue untreated will lead to the development of amblyopia. Treatment options for esotropia include glasses to correct refractive errors, the use of prisms, orthoptic exercises, or eye muscle surgery.

The National Eye Institute (NEI) is part of the U.S. National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services. The mission of NEI is "to eliminate vision loss and improve quality of life through vision research." NEI consists of two major branches for research: an extramural branch that funds studies outside NIH and an intramural branch that funds research on the NIH campus in Bethesda, Maryland. Most of the NEI budget funds extramural research.

Orthoptics is a profession allied to the eye care profession. Orthoptists are the experts in diagnosing and treating defects in eye movements and problems with how the eyes work together, called binocular vision. These can be caused by issues with the muscles around the eyes or defects in the nerves enabling the brain to communicate with the eyes. Orthoptists are responsible for the diagnosis and non-surgical management of strabismus (cross-eyed), amblyopia and eye movement disorders. The word orthoptics comes from the Greek words ὀρθός orthos, "straight" and ὀπτικός optikοs, "relating to sight" and much of the practice of orthoptists concerns disorders of binocular vision and defects of eye movement. Orthoptists are trained professionals who specialize in orthoptic treatment, such as eye patches, eye exercises, prisms or glasses. They commonly work with paediatric patients and also adult patients with neurological conditions such as stroke, brain tumours or multiple sclerosis. With specific training, in some countries orthoptists may be involved in monitoring of some forms of eye disease, such as glaucoma, cataract screening and diabetic retinopathy.

<span class="mw-page-title-main">Strabismus</span> Eyes not aligning when looking at something

Strabismus is a vision disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a large part of childhood, it may result in amblyopia, or lazy eyes, and loss of depth perception. If onset is during adulthood, it is more likely to result in double vision.

<span class="mw-page-title-main">Amblyopia</span> Failure of the brain to process input from one eye

Amblyopia, also called lazy eye, is a disorder of sight in which the brain fails to fully process input from one eye and over time favors the other eye. It results in decreased vision in an eye that typically appears normal in other aspects. Amblyopia is the most common cause of decreased vision in a single eye among children and younger adults.

<span class="mw-page-title-main">Diplopia</span> Double vision

Diplopia is the simultaneous perception of two images of a single object that may be displaced horizontally or vertically in relation to each other. Also called double vision, it is a loss of visual focus under regular conditions, and is often voluntary. However, when occurring involuntarily, it results from impaired function of the extraocular muscles, where both eyes are still functional, but they cannot turn to target the desired object. Problems with these muscles may be due to mechanical problems, disorders of the neuromuscular junction, disorders of the cranial nerves that innervate the muscles, and occasionally disorders involving the supranuclear oculomotor pathways or ingestion of toxins.

Pediatric ophthalmology is a sub-speciality of ophthalmology concerned with eye diseases, visual development, and vision care in children.

Vision therapy (VT), or behavioral optometry, is an umbrella term for alternative medicine treatments using eye exercises, based around the pseudoscientific claim that vision problems are the true underlying cause of learning difficulties, particularly in children. Vision therapy has not been shown to be effective using scientific studies, except for helping with convergence insufficiency. Most claims—for example that the therapy can address neurological, educational, and spatial difficulties—lack supporting evidence. Neither the American Academy of Pediatrics nor the American Academy of Ophthalmology support the use of vision therapy.

<span class="mw-page-title-main">Exotropia</span> Visual disorder where eyes work independently

Exotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of esotropia and usually involves more severe axis deviation than exophoria. People with exotropia often experience crossed diplopia. Intermittent exotropia is a fairly common condition. "Sensory exotropia" occurs in the presence of poor vision in one eye. Infantile exotropia is seen during the first year of life, and is less common than "essential exotropia" which usually becomes apparent several years later.

The Optometric Extension Program Foundation (OEPF) is an international, non-profit organization dedicated to the advancement of the discipline of optometry, with recent emphasis on behavioral optometry and vision therapy.

<span class="mw-page-title-main">Sixth nerve palsy</span> Inability to turn out the eye due to dysfunction of the abducens nerve

Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI, which is responsible for causing contraction of the lateral rectus muscle to abduct the eye. The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the primary symptom is diplopia in which the two images appear side-by-side. Thus, the diplopia is horizontal and worse in the distance. Diplopia is also increased on looking to the affected side and is partly caused by overaction of the medial rectus on the unaffected side as it tries to provide the extra innervation to the affected lateral rectus. These two muscles are synergists or "yoke muscles" as both attempt to move the eye over to the left or right. The condition is commonly unilateral but can also occur bilaterally.

<span class="mw-page-title-main">Worth 4 dot test</span> Clinical test for binocular vision

The Worth Four Light Test, also known as the Worth's four dot test or W4LT, is a clinical test mainly used for assessing a patient's degree of binocular vision and binocular single vision. Binocular vision involves an image being projected by each eye simultaneously into an area in space and being fused into a single image. The Worth Four Light Test is also used in detection of suppression of either the right or left eye. Suppression occurs during binocular vision when the brain does not process the information received from either of the eyes. This is a common adaptation to strabismus, amblyopia and aniseikonia.

<span class="mw-page-title-main">Hypertropia</span> Condition of misalignment of the eyes

Hypertropia is a condition of misalignment of the eyes (strabismus), whereby the visual axis of one eye is higher than the fellow fixating eye. Hypotropia is the similar condition, focus being on the eye with the visual axis lower than the fellow fixating eye. Dissociated vertical deviation is a special type of hypertropia leading to slow upward drift of one or rarely both eyes, usually when the patient is inattentive.

Infantile esotropia is an ocular condition of early onset in which one or either eye turns inward. It is a specific sub-type of esotropia and has been a subject of much debate amongst ophthalmologists with regard to its naming, diagnostic features, and treatment.

Dichoptic is viewing a separate and independent field by each eye. In dichoptic presentation, stimulus A is presented to the left eye and a different stimulus B is presented to the right eye.

<span class="mw-page-title-main">Stereopsis recovery</span> Medical phenomenon

Stereopsis recovery, also recovery from stereoblindness, is the phenomenon of a stereoblind person gaining partial or full ability of stereo vision (stereopsis).

Alternating occlusion training, also referred to as electronic rapid alternate occlusion, is an approach to amblyopia and to intermittent central suppression in vision therapy, in which electronic devices such as programmable shutter glasses or goggles are used to block the field of view of one eye in rapid alternation.

Binasal occlusion is a method of partial covering (occlusion) of the visual field of the two eyes in which the sector of the visual field that is adjacent to the nose is occluded for each eye. It is a well-known procedure in vision therapy.

The management of strabismus may include the use of drugs or surgery to correct the strabismus. Agents used include paralytic agents such as botox used on extraocular muscles, topical autonomic nervous system agents to alter the refractive index in the eyes, and agents that act in the central nervous system to correct amblyopia.

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