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Aims and Objectives: The aim was to compare the effectiveness between patching and non-patching in the treatment of non-infected, non-contact lens related traumatic corneal abrasions, as well as of abrasions following foreign body removal. Materials and Methods: A prospective, controlled, randomized study on 100 patients over 1 year who presented with ocular pain, with a history of trauma or foreign body removal & had corneal abrasion on fluorescein stain. Patients were randomized into two groups: with patch group (receiving an eye patch with topical antibiotics) and no patch group (topical antibiotics with no eye patch) and patients were followed up. Results: Patients with corneal abrasions healed significantly faster and relieved symptomatically in the no patch group. Conclusion: We conclude that routine use of eye patching is not effective in the healing of simple corneal abrasion. Keywords: Corneal abrasion, Corneal foreign body removal, Fingernail injury, Patching.

BACKGROUND: Currently there is no consensus on which are the characteristics of rehabilitation approaches (bottom-up or top-down) most effective in the rehabilitation of ADLs in people with Neglet Syndrome (NS). AIM: To characterize the approaches (bottom-up or top-down) with more impact on ADLs in adults and elderly with NS. METHODS: This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendation. A bibliographic search was carried out in PubMed, Web of Science, PEDro and Cochrane databases. Experimental studies were considered in which at least one technique of the bottom-up and top-down approaches was used. The Joanna Briggs Institute Critical Appraisal Checklist for RCTs tool was used to assess the methodological quality of the studies. The following combination of keywords was used: Negligence Syndrome OR Unilateral Syndrome OR Negligence (...) AND Activities OF Daily OR Daily Life (...) AND Treatment OR Intervention OR Technique (...). RESULTS: 16 studies were included, which 9 include techniques from the bottom-up approach, 6 include techniques from the top-down approach and 1 article includes two techniques, each belonging to each approach. The techniques of the bottom-up approach that increased independence in the ADLs were Visuomotor Feedback Training, Smooth Pursuit Eye Movement Training and the combination of Eye Patching with Constraint-induced Therapy. In the top-down approach, the techniques with the same results were Visual Scanning, Mental Practice, Continuous Theta Burst Stimulation and Transcranial Direct Current Stimulation. CONCLUSION: Both bottom-up and top-down approaches increase independence in ADLs. Each approach contains techniques with a significant positive impact on ADLs such as Visuomotor Feedback Training and Continuous Theta Burst Stimulation. The present work also allowed a critical analysis to the classification of the approaches in bottom-up and top-down, since they are not different to the category of rehabilitation mechanisms.

Background Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies. Methods We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient. Results Following eye patching and steroid treatment, at 6-week follow-up the patient's pain had significantly improved however the complete IIIrd nerve palsy remained. Conclusions Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma.

Amblyopia or lazy eyes is a unilateral or bilateral Disorder and reduction of best-corrected visual acuity (BCVA) which affected approximately 3% of the world’s population. To improve the visual deficits caused by Amblyopia, the traditional treatments have to be implemented before the termination of the critical visual development period which is within the age of 6–12 years. Despite traditional opinions that amblyopia treatment is only effective for children through treatment such as eye patching, video games could be highly engaging and improve vision and attention in the adult with amblyopia.

Purpose: Patients with blepharoptosis who are treated with Müller’s muscle-conjunctival resection (MMCR) may experience postoperative pain and discomfort related to the suture material on the palpebral conjunctiva. This study aims to compare the postoperative subjective complaints, such as pain and discomfort, with a visual analog scale (VAS), and objectively evaluate the cornea with a tear break-up time (TBUT) test and fluorescein staining following MMCR that was managed by either a bandage contact lens (BCL) or eye patching. Methods: Forty patients who had undergone a unilateral MMCR were randomized into 2 groups. Group 1 (n = 20) received a BCL, and group 2 (n = 20) received an eye patch following the MMCR. Patients were evaluated postoperatively at 1 and 7 days in this prospective study. The postoperative pain was measured using a VAS, and the requirement for anti-inflammatory medication was analyzed. A slit-lamp examination was performed to evaluate the cornea with a TBUT test and fluorescein staining by objectively using the National Eye Institute (NEI) classification. Results: BCL treatment decreased the VAS score, the need for anti-inflammatory medications, and fluorescein staining using the NEI score and increased the TBUT score significantly compared with the eye patch treatment (p < 0.001). Conclusions: Our findings suggest that the use of a BCL may be beneficial in terms of reducing early postoperative pain and eye stinging, protecting the cornea, and retaining the ability to perform daily activities following a MMCR.

Purpose To evaluate the effect of postoperative eye patching after routine cataract surgery on corneal oedema and visual acuity on the first postoperative day. Setting One public healthcare centre. Design and methods This randomized controlled trial included patients undergoing uneventful cataract surgery in one medical centre. Patients were randomized into two groups: the surgical eye was patched with a single dose of a local steroid and antibiotic for 24 hr in the first group, and a plastic shield was used in the second with local steroid and antibiotic drops. The eyes were examined preoperatively and on the first postoperative day. Examination included the following: best-corrected visual acuity (BCVA), full slit lamp examination, intraocular pressure (IOP), anterior chamber depth (ACD) and central corneal thickness (CCT) using the IOL Master 700 (Zeiss, Germany). Cumulative dissipated energy (CDE) and operation time were recorded for all cases. Results One hundred eyes of 100 patients were included in the study. The postoperative increase in CCT 24 hr after surgery was 138 and 70 µm in the patched group as compared to the non-patched group, respectively (p = 0.001). Best-corrected visual acuity (BCVA) on the first postoperative day was 0.5 ± 0.45 LogMAR and 0.3 ± 0.3 LogMAR in the patched and non-patched group, respectively (p = 0.01). There was no difference in CDE (11.33 ± 9.2 and 10.22 ± 7.3; p = 0.94) between the two groups. Conclusions Eye patching after routine cataract surgery is associated with an increase in corneal oedema and slower visual recovery on the first postoperative day.

PURPOSE To investigate the feasibility, effectiveness and acceptability of using prosthetic occluding contact lenses (OCLs) to treat moderate amblyopia in adults and of the role of the multifocal visual evoked potential (mfVEP) as a predictor of postamblyopic therapy. METHODS A comparative, prospective, interventional, case series pilot study with amblyopic adults (mean age: 40 years, range 20-50 years) allocated into two intervention groups: eye patching and OCL. The primary outcome variable was logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and secondary outcomes were mfVEP amplitude and latency and patients' health-related quality of life National Eye Institute Visual Function Questionnaire (NEI VFQ-25). RESULTS Significant improvements in pre- to postamblyopic therapy BCVA were seen at 1.5 months in the OCL group [0.29 logMAR, 95% confidence interval (CI): 0.10-0.47 versus 0.11 logMAR, 95% CI: 0.02-0.19; p

Objective: To compare the effect of visual spatial training on the spatial attention to that on motor control and to correlate the improvement of spatial attention to motor control progress after visual spatial training in subjects with unilateral spatial neglect (USN). Method: 9 cases with USN after right cerebral stroke were randomly divided into Conventional treatment group + visual spatial attention and Conventional treatment group. The Conventional treatment group + visual spatial attention received conventional rehabilitation therapy (physical and occupational therapy) and visual spatial attention training (optokinetic stimulation and right half-field eye patching). The Conventional treatment group was only treated with conventional rehabilitation training (physical and occupational therapy). All patients were assessed by behavioral inattention test (BIT), Fugl-Meyer Assessment of motor function (FMA), equilibrium coordination test (ECT) and non-equilibrium coordination test (NCT) before and after 4 weeks treatment. Result: Total scores in both groups (without visual spatial attention/with visual spatial attention) improved significantly (BIT: P=0.021/P=0.000, d=1.667/d=2.116, power=0.69/power=0.98, 95%CI[-0.8839,45.88]/95%CI=[16.96,92.64]; FMA: P=0.002/P=0.000, d=2.521/d=2.700, power=0.93/power=0.98, 95%CI[5.707,30.79]/95%CI=[16.06,53.94]; ECT: P=0.002/ P=0.000, d=2.031/d=1.354, power=0.90/power=0.17, 95%CI[3.380,42.61]/95%CI=[-1.478,39.08]; NCT: P=0.013/P=0.000, d=1.124/d=1.822, power=0.41/power=0.56, 95%CI[-7.980,37.48]/95%CI=[4.798,43.60],) after treatment. Among the 2 groups, the group with visual spatial attention significantly improved in BIT (P=0.003, d=3.103, power=1, 95%CI[15.68,48.92]), FMA of upper extremity (P=0.006, d=2.771, power=1, 95%CI[5.061,20.14]) and NCT (P=0.010, d=2.214, power=0.81-0.90, 95%CI[3.018,15.88]). Correlative analysis shows that the change of BIT scores is positively correlated to the change of FMA total score (r=0.77, P

Objective Recently, eye patching has been used as a technique for adjusting visual information. However, there are differing opinions regarding the influence of eye patching on visual attention in hemispatial neglect. Studies on eye patching do not usually consider the effects of differences in task difficulty or reaction space. Moreover, to date, no trial has used neglected-field eye patching. We investigated the effect on hemispatial neglect of hemi-visual field eye-patching glasses in a patient with left spatial neglect. Methods The patient was an 86-year-old woman who had suffered a stroke. She had severe left hemiparesis and left spatial neglect. Three types of eye-patching glasses were used: right-field patching, left-field patching, and no patching. The line bisection test, the line crossing test, the star cancellation test, and the letter cancellation test were carried out for the three eye-patching conditions. Results The line bisection test results showed rightward deviations for both left and right patching compared to no patching. For the line crossing test, there were no omission errors for any patching condition. In the star cancellation test, there were small differences between the three patching conditions. However, in the letter cancellation test, the fewest omission errors occurred during left-field patching, with the most notable improvement on the right half of the test paper. Conclusion The results suggest that neglected-field eye patching for hemispatial neglect might improve visual attention, especially the non-spatial aspects.

Purpose To investigate the effects of postoperative eye patching on clear corneal incision architecture in phacoemulsification. Design A single-center, randomized controlled trial. Methods A total of 132 patients with uncomplicated phacoemulsification were randomly allocated to the intervention or control group. The intervention group received postoperative eye patching for approximately 18 hours, whereas the control group received eye shield. The clear corneal incision architecture was examined postoperatively at 2 hours, 1 day, and 7 days after surgery using optical coherence tomography. Results Epithelial gaping was significantly reduced on postoperative day 1 in the intervention group (52.4%) compared with control (74.2%) (P = 0.01). No differences were found for other architectural defects. Descemet membrane detachment was associated with lower intraocular pressure on postoperative day 7 (P = 0.02). Presence of underlying diabetes mellitus did not seem to influence architectural defects. Conclusions Postoperative eye patching facilitated epithelial healing and reduced the occurrence of epithelial gaping on postoperative day 1. It may play a role in protecting and improving corneal wounds during the critical immediate postoperative period.

Congenital bilateral upper eyelids eversion is rare clinical condition. However it is known to be associated with collodion baby, Down syndrome and children of black race. This condition responds well to early active conservative management. We reported a case of congenital bilateral upper eyelids eversion in a collodion neonate delivered by 21 year old lady at home through a spontaneous vaginal delivery. This case was successful managed with lid reposition, topical antibiotic and eye patching.

Background: Complex visual hallucinations in the presence of a clear mental state and in the absence of underlying neurological disorders have received increased recognition since Charles Bonnet reported visual hallucinations secondary to mature cataracts in 1760. The prevalence of Charles Bonnet syndrome (CBS) varies widely in the literature and might be underestimated in most settings. The current paper presents a case of acute-onset CBS due to a unilateral Frost suture after revision of an orbit floor fracture. Case report: A 68-year-old male patient underwent an operation to repair a unilateral orbital floor fracture and subsequent eye patching by a Frost suture. The patient complained of complex, colored visual hallucinations ∼3h after waking from general anesthesia. The visual hallucinations stopped during sleep and reappeared in the morning. The symptoms disappeared completely ∼2h after removal of the Frost suture. Discussion: Frost sutures are commonly used in oculoplastic surgery and may result in acute onset of visual hallucinations. CBS is often neglected, and clinicians must be aware of the association between acute visual deprivation and CBS.

PubMedID: 21647569 Purpose To investigate the effects of full-time patching regimen on the treatment of amblyopia in children aged 10-16 years. Methods Forty-seven patients with a mean age of 12.09 ± 1.65 years were included in this study. All of the patients received eye patching for the entire day, 6 days a week, during the first 3 months. The patients who achieved visual acuity of 0.00 logMAR at the third month were provided with additional patching treatment (4-6 h/day). On the other hand, the patients who showed no change in their visual acuity or an increase of less than 0.00 logMAR at the third month had 3 more months of eye patching for the entire day, 6 days a week. Results Prior to treatment, the best mean visual acuity of the amblyopic eyes was 0.48 ± 0.25 (range 1.00-0.15) logMAR. After follow-up, the visual acuity of the amblyopic eyes was 0.20 ± 0.22 (range 1.00-0.00) logMAR. Thus, visual acuity in the amblyopic eyes improved by 0.2 log unit or more in 38 of 47 patients (81%). Conclusions The present results show that patching in older children with amblyopia improves visual acuity with no serious complications. The use of patching in children to improve amblyopia seems promising. © Japanese Ophthalmological Society 2011.

Background: This study investigated the use of corneal volume to monitor the corneal swelling response induced by wearing high plus power contact lenses. Methods: Twelve young non-contact lens wearers were recruited with one eye fitted with a soft contact lens (Polymacon material, 38.6 per cent water, Dk of 9 and 0.27 mm centre thickness) and the fellow eye served as control. The treated eye was patched for two hours leaving the control eye uncovered. Central corneal thickness (CCT) was measured with non-contact specular microscopy and corneal volumes (at three, five and 10 mm zones) were measured with a corneal topographer (Pentacam, Oculus Inc, Germany), before eye patching as well as immediately after and every 20 minutes for 100 minutes. Results: Subjects had similar CCT and corneal volumes between the two eyes before treatment. The treatment eyes showed a mean corneal swelling of 8.1 per cent immediately after lens removal. Corneal volume was significantly increased at the three (mean swelling of 5.9 per cent), five (5.6 per cent) and 10 millimetre (3.3 per cent) zones. It took 20 minutes for the corneal volume at the 10 mm zone to return to baseline but required 60 minutes for the three and five millimetre zones to return to the baseline level. The central corneal thickness was still significantly thicker 80 minutes after patching. Conclusion: Corneal volume could be a useful parameter to monitor corneal change when an event affects the entire cornea. Corneal volume combined with central corneal thickness could give more comprehensive information to monitor central corneal swelling.

Objectives: This study was designed with the primary objective to compare between eye patching and cyanoacrylate glue application for anterior chamber (AC) reformation in infected perforated corneal ulcers. Subjects and Methods: This is a nonrandomized prospective comparative study conducted in a tertiary eye hospital. Patients with perforated keratitis were offered either eye patching (Group 1) or cyanoacrylate gluing (Group 2) under hospital admission and medical treatment to reform the AC. Success was defined as a formed AC at the time of discharge from the hospital. Patients were followed up to 1 month after discharge. Normally distributed data were expressed as mean ± standard deviation and skewed data as median. Nominal data between the two groups were compared using Chi-square test or Fisher's exact test. Results: Forty eyes underwent eye patching and 38 eyes cyanoacrylate gluing to reform the AC. The number of eyes with formed AC was more in Group 2 (92%) compared to Group 1 (70%) (P = 0.020). Subgroup analysis on the basis of the size of perforation and size of ulcer showed that AC reformation was better in Group 2 compared to Group 1 in all aspects [Table 1]. In intragroup analysis, success in Group 1 was significantly better in small perforations (P = 0.001) and in small ulcers (P = 0.032) and ulcer in central location (P = 0.004). In Group 2, there was no significant difference in AC reformation between small and large perforation or ulcer. In both groups, AC reformation in peripheral perforations was poor compared to central and paracentral perforations (P = 0.004, 0.032). Conclusions: Cyanoacrylate glue is better than eye patching to restore ocular integrity. However, eye patching showed promising results in subgroup of patients with small perforated ulcers.{Table 1}

We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.

Temporarily depriving one eye of its input, in whole or in part, results in a transient shift in eye dominance in human adults, with the patched eye becoming stronger and the unpatched eye weaker. However, little is known about the role of colour contrast in these behavioural changes. Here, we first show that the changes in eye dominance and contrast sensitivity induced by monocular eye patching affect colour and achromatic contrast sensitivity equally. We next use dichoptic movies, customized and filtered to stimulate the two eyes differentially. We show that a strong imbalance in achromatic contrast between the eyes, with no colour content, also produces similar, unselective shifts in eye dominance for both colour and achromatic contrast sensitivity. Interestingly, if this achromatic imbalance is paired with similar colour contrast in both eyes, the shift in eye dominance is selective, affecting achromatic but not chromatic contrast sensitivity and revealing a dissociation in eye dominance for colour and achromatic image content. On the other hand, a strong imbalance in chromatic contrast between the eyes, with no achromatic content, produces small, unselective changes in eye dominance, but if paired with similar achromatic contrast in both eyes, no changes occur. We conclude that perceptual changes in eye dominance are strongly driven by interocular imbalances in achromatic contrast, with colour contrast having a significant counter balancing effect. In the short term, eyes can have different dominances for achromatic and chromatic contrast, suggesting separate pathways at the site of these neuroplastic changes.

The right half-field eye-patching technique has been reported to be effective in reducing unilateral neglect (UN) and improving functional ability in stroke patients. This study investigated the efficacy of conventional treatment with right half-field eye patching in treating subacute stroke patients with UN, using a randomised controlled trial.Thirty-five inpatients with subacute stroke were recruited and randomised into intervention and control groups. The patients in the intervention group received 4 weeks of conventional occupational therapy with modified right half-field eye-patching. Those in the control group received 4 weeks of conventional treatment only. Assessors, who were blind to the treatments, assessed the groups using the Behavioural Inattention Test (BIT) and the Functional Independence Measure (FIM) on admission and at 4 weeks.Patients treated with right half-field eye-patching had significantly (p = 0.046) higher BIT gain (mean = 25.06, SD = 30.81) than those treated with the conventional treatment (mean = 8.29, SD = 10.35). There was no significant difference (p = 0.467) in FIM gain between patients in both groups.Right half-field eye-patching improved stroke patients' impairment level in terms of UN, but the potential benefits in impairment tests were not confirmed by improvements in function.

Video game play induces a generalized recovery of a range of spatial visual functions in the amblyopic brain. Here we ask whether video game play also alters temporal processing in the amblyopic brain. When visual targets are presented in rapid succession, correct identification of the first target (T1) can interfere with identification of the second (T2). This is known as the "attentional blink". We measured the attentional blink in each eye of adults with amblyopia before and after 40 hours of active video game play, using a rapid serial visual presentation technique. After videogame play, we observed a ~40% reduction in the attentional blink (identifying T2 200 ms after T1) seen through the amblyopic eye and this improvement in performance transferred substantially to the untrained fellow sound eye. Our experiments show that the enhanced performance cannot be simply explained by eye patching alone, or to improved visual acuity, but is specific to videogame experience. Thus, videogame training might have important therapeutic applications for amblyopia and other visual brain disorders.

Congenital bilateral upper eyelid eversion is a rare condition and the definite cause is not known. It is often seen in Black babies or babies with Down’s syndrome. With early diagnosis and appropriate treatment, the condition can be managed without surgery. We report a case of congenital upper eyelid eversion in an otherwise healthy Caucasian neonate, born by normal vaginal delivery. The case responded well to conservative treatment, including eyelid repositioning, lubricants, antibiotic ointment, and eyelid patching.

Monocular patching has been advocated as a treatment for spatial neglect. Eye patching, however, is also reported to increase spatial bias. Thus, patching brain injury patients for ocular conditions may also impair their attention. To learn if an eye patch may induce asymmetric attention in a patient without spatial neglect, we tested a woman with diplopia after a left thalamic-intraventricular hemorrhage. She had no spatial neglect on bedside attention tasks. Using a laser pointer, she bisected a blank space at near (279 mm) and far (914 mm) distances under 3 conditions: unpatched and wearing a right or left eye patch. Unpatched, she showed no bias. She erred further leftward with right patching at both distances. Right eye patching appeared to induce neglect of right space when the patient performed this task. With left patching, leftward error tended to increase in near space only. Clinicians prescribing eye patches to patients with brain injury even for purely ocular indications, should evaluate them for spatial neglect once the patch is in place.

Background and Purpose— Right hemisphere stroke patients frequently experience spatial neglect, a severe lack of awareness for contralesional hemispace. Although neglect counts among the strongest predictors for poor functional outcome after stroke, there is no established therapy, particularly not for the acute stage. Methods— In a randomized controlled trial, we compared the combined treatment of hemifield eye patching and repetitive optokinetic stimulation in acute stroke patients with neglect to the spontaneous course. Outcome measures were a neuropsychological test battery for neglect as well as scales of functional independence and clinical impairment. Outcomes were assessed at baseline (day 1), post treatment (day 8), and at 1-month follow-up (day 30). Results— Final analysis included 21 acute right hemisphere stroke patients with neglect (23 enrolled, 2 lost to follow-up) allocated either to the treatment (1 week hemifield eye patching and daily sessions of optokinetic stimulation, n=11) or the control group (no neglect-specific treatment, n=10). At baseline, both groups did not differ in neuropsychological test performance, clinical impairment, or functional disability. At the post treatment session, both groups had improved in all these measures, and results were stable or further improved at follow-up. However, there was no significant difference in this change between the treatment and the control group. Conclusions— An early intervention of combined hemifield eye patching and optokinetic stimulation in acute stroke patients with spatial neglect has no additive effect to the spontaneous remitting course of the disorder. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01617343.

Right half-field eye-patched glasses intervention was performed in two chronic stroke patients with unilateral spatial neglect. Eye movement on the neglect side, the center of gravity as an index of the internal midline bias, neglect sign tests, and the regional cerebral blood flow (rCBF) were measured before and after intervention. The improvement of eye movement was not shown clearly after intervention. The center of gravity shifted significantly to the right and backward. Letter and star cancellation tests were improved in both the cases. Line bisection test showed improvement in one patient. However, line cancellation and line bisection tests were worsened in the other. The rCBF was not changed after intervention. This case study suggests that right half-field eye patching might not be an effective intervention.

The effects of administration of topical 1% indomethacin vs semipressure patching were studied in a prospective, randomized, masked study of 28 patients with symptomatic corneal abrasion of 3 mm or less. One group of 14 patients received topical antibiotic and administration 4 times daily of topical indomethacin. The other 14 patients were treated with topical antibiotic, and the traumatized eye was patched. After 6 to 9 hours, indomethacin-treated eyes had less pain and itching. After 24 hours, there was no difference between groups except that itching remained significantly greater in patched eyes.

A qualitative investigation was conducted to explore, from the parents' perspective, the psychological effects of eye patching children and issues affecting compliance with the treatment for amblyopia. Protection motivation theory (PMT; Rogers, 1983) was employed as a conceptual framework from which to formulate questions for semi-structured interviews. A total of 20 families attending outpatient appointments at an orthoptic clinic agreed to participate. The application of PMT played a useful role in delineating the dynamic relationship between parents' perceptions of amblyopia and their ability to undertake the treatment. Parents were cognisant of the efficacy of patching for their child's condition and this was linked to the perceived severity and consequences of the condition, with a high value placed on having good visual ability in both eyes. However, due to the level of psychological distress associated with patching for both the child and parents, regular compliance was often difficult to achieve. ...

Two experiments examined aggressive responding in Anolis carolinensis. In experiment one, ten adult male anoles had either their left (LEP) or right (REP) eye patched and were then subjected to ten behavioral trials during which a second male was introduced into the cage. Greater numbers of headbobs, or bites, were observed during the LEP condition, while greater numbers of dewlaps and head bobs were observed during the REP condition. In addition, while baseline skin color showed no difference between groups, by the completion of the trials LEP greened, while REP browned. Changes in skin color were correlated with aggressive responding, with a “greening effect” showing high correlation with increased aggression, while browning was associated with decreased responding. In experiment two, 15 unpatched A. carolinensis males served as subjects and were subjected to 19 5 min trials during which an antagonistic male was placed into the cage. In these subjects, a preference for left-eye aggression was found to develop over the course of the first 6 days of training, while a decrease in use of the right eye simultaneously occurred. Following injection with fluoxetine, a decrease in aggressive responding in both the right and left eyes was found in comparison to the control group. Collectively, these results suggest that the lateralized control of aggression in A. carolinensis is more complicated than suggested by observation of unpatched subjects, although in both conditions the social assertation response (i.e., dewlaps plus headbobbing) is predominantly under the control of the left eye/right hemisphere. J. Exp. Zool. 278:9–21, 1997. © 1997 Wiley-Liss, Inc.

Monocular occlusion has been posited to reduce activation of the contralateral hemisphere ("Sprague effect"), thus inducing a contralateral spatial bias (toward the viewing eye). Healthy right-handed participants bisected horizontal lines during monocular eye viewing. Although subjects tended to deviate away from the viewing eye, only left-eye viewing deviated significantly right of midline. These results suggest that eye patching may induce an attentional compensation similar to that in hemianopic patients. Alternatively, increased activation of higher cortical regions mediating spatial attention in contralateral hemispace may be an adaptive response to decreased activation of its ipsilateral superior colliculus induced by contralateral eye patching.

Charles Bonnet syndrome (CBS) is characterised by recurrent vivid visual hallucinations in the presence of normal cognition. We present a case of CBS secondary to eye patching following Pars Plana Vitrectomy with an unusually acute onset in a 48-year-old woman. She presented with formed visual hallucinations that started less than 30 min after patching of her left eye. The patch was removed after 2 d, and these hallucinations persisted 2 d following eye patch removal. It is important that the ophthalmic surgeon be aware of the potential for development of CBS and offer appropriate referral and reassurance should it occur.

Eye patching (EP; monocular or right hemifield) has been proposed to improve visuospatial attention to the ignored field in patients with hemispatial neglect. The aim of this paper is to review the literature on the effects of EP in hemispatial neglect after stroke in order to convey evidence-based recommendations to clinicians in stroke rehabilitation. Thirteen intervention studies were selected from the Medline, EMBASE, Scopus, Cochrane Library, CINAHL, PsychINFO, EBRSR, and Health Star databases. Methodological quality was defined according to the Physiotherapy Evidence Database. Overall, seven studies used monocular EP, five used right hemifield patching, and one compared right monocular with right hemifield patching. Seven studies compared normal viewing to monocular or hemifield patching conditions. Six studies included a period of treatment. As to the monocular EP, four studies reported positive effects of right monocular patching. One study showed an improvement in hemispatial neglect with left monocular patching. Two studies found no superiority of right vs. left monocular patching. One study found no effects of right monocular patching. As to the right hemifield EP, one study showed improvements in neglect after right hemifield patching. Three studies found that right hemifield patching combined with another rehabilitation technique was more effective than that treatment alone. One study found no differences between right hemifield patching combined with another treatment and that treatment alone. One study found the same effect between right hemifield patching alone and another rehabilitation technique. Our results globally tend to support the usefulness of right hemifield EP in clinical practice. In order to define a level of evidence with the standard rehabilitation evidence rating tools, further properly powered randomized controlled trials or meta-analysis are needed.

Standard treatment of corneal epithelial loss includes an eye patch with antibiotic ointment. We compared the efficacy of eye patching with no eye patching on corneal epithelial healing of 84 patients after foreign body removal. Since no significant difference between two groups for corneal healing was found, antibiotic treatment alone may be sufficient for treatment of corneal epithelial loss after foreign body removal.

A 58-year-old man presented with corneal dellen twelve days after pterygium removal on his left eye. Initial treatment with lubrication and artificial tears was unsuccessful. The fitting of a conventional contact lens was not possible because of conjuctival chemosis. Additionally the patient denied eye patching due to professional reasons. As an alternative treatment a large diameter bandage soft contact lens approved for extended wear was applied ((David Thomas Contact Lens T74/85 Extended Wear/Bandage of 18 mm diameter). The next day corneal dellen had already began to retreat and four days later the contact lens was removed since there was no sign of dellen in the slit lamp examination. In conclusion, the use of a large diameter soft contact lens was an effective alternative solution for the treatment of corneal dellen in our patient.

Objective The aim of this study was to report a case of Charles Bonnet syndrome secondary to eye patching following eyelid reconstruction with an unusually acute onset. Method An observational case report was conducted. Results The patient reported complex visual hallucinations that started less than 10 minutes after patching of her right eye (the left eye had poor vision from previous trauma). The patch was removed after 2 days, and the hallucinations gradually stopped over the subsequent 2 days. Conclusion This case of Charles Bonnet syndrome describes an unusually acute onset of hallucinations and is only the second reported case following eye patching. Eye patching is commonly used in a number of situations, and it is important to be aware of this association, as the diagnosis of Charles Bonnet syndrome is often overlooked.

Objective : To investigate the effectiveness of voluntary trunk rotation and half-field eye-patching to treat patients with unilateral neglect in stroke. Design : Pre—post, day 60 follow-up, single-blinded randomized controlled trial. Setting : Single-centre inpatient rehabilitation hospital. Subjects : Sixty subacute patients with right hemisphere stroke having unilateral neglect within eight weeks post stroke consented to participate between November 2003 and July 2005. They were randomly assigned to three comparison groups. Interventions : Nineteen patients received daily experimental training in voluntary trunk rotation (TR) for 1 hour five times a week for 30 days. Twenty patients received the same kind of treatment together with half-field eye-patching (TR + EP). Fifteen patients in the control group received conventional training with the same contact time. Main outcome measures : Patients were assessed on days 0, 30 and 60 using the Behavioural Inattention Test, the Clock Drawing Test, and the Functional Independence Measure. Results : No significant differences between voluntary trunk rotation (TR), voluntary trunk rotation and half-field eye-patching (TR + EP) and controls were found in functional performance and neglect measures at day 30 (P = 0.042—0.994) and follow-up (P = 0.052—0.911) at P = 0.005 using Bonferroni correction. Conclusions : The results of this study do not support the use of voluntary trunk rotation alone or with half-field eye-patching to improve functional performance or reduce unilateral neglect in subacute patients with stroke.

The traditional use of patching and topical antibiotics in the treatment of corneal abrasion has recently been challenged, particularly after foreign body removal. In a prospective, controlled, randomized study of 33 patients treated in the emergency department for eye pain and corneal abrasion, we attempted to determine whether eye patching affected the pain of simple corneal abrasions. After fluorescein examination with magnification (x 5), a visual analog pain score was recorded and the patient was randomized to either the patched or nonpatched group. A standard analgesic was supplied, and all patients had follow-up at 24 hours, when repeat pain scores and analgesic use were recorded. The groups were compared by using the Wilcoxon's rank sum test, Student's t test, and analysis of covariance as required. There was no significant difference in the mean changes in pain scores between the patched and nonpatched groups. Analgesic use was also similar. We conclude that routine eye patching does not favorably affect the pain associated with the treatment of simple corneal abrasion.

EDITOR—In their ABC of eyes Khaw et al recommend three treatments for corneal abrasion, none of which seem to be supported by the literature.1 A meta-analysis of studies of eye patching …

Objectives: This study reports an application of protection motivation theory (PMT) to the prediction of parental adherence to eye patching recommendations for children with amblyopia over a 2-month period. The study also considered the role of past behaviour in PMT. Design and methods: A total of 151 parents of children with amblyopia who were attending follow-up appointments for orthoptic treatment participated. They completed questionnaires based on PMT to assess their beliefs about amblyopia and eye patching. Of the parents, 105 were contacted again at 2-month follow-up to obtain a measure of adherence to the recommended treatment for their child. Results: PMT was found to be predictive of adherence intentions and behaviour at 2-month follow-up. Regression analyses revealed perceived vulnerability, response efficacy and self-efficacy to be significant predictors of protection motivation, whereas perceived vulnerability and response costs were significant predictors of adherence behaviour. Past adherence behaviour was found to have a direct effect on future adherence behaviour over and above the influence of PMT. Conclusions: The results are discussed in relation to the sufficiency of PMTas a model of adherence behaviour. The practical implications for attempts to increase adherence to eye patching among children with amblyopia are outlined.

A 30-year-old female with known Pierre Robin sequence presented to the emergency department of the Royal Victorian Eye and Ear Hospital, Melbourne, with acute unilateral hydrops as her first presentation of bilateral keratoconus. Initial management consisted of eye patching, hypertonic saline and cycloplegia. However, the long-term prognosis for visual rehabilitation remained poor in this patient because of the presence of a central corneal opacity and inability to comply with contact lenses. She was not an appropriate candidate for keratoplasty due to severe mental retardation. This report highlights an association of keratoconus in patients with the Pierre Robin sequence.

Bullying and eye patching The psychological impact that patching treatment for amblyopia might have on children and their families was highlighted in an influential review of amblyopia screening.1 A recent randomised trial investigating the efficacy of patching for amblyopia has reported that 4 year old and 5 year old children were significantly more upset by receiving patching and glasses than by receiving glasses only, as were the parents of the 4 year olds undergoing treatment, suggesting that patching treatment can be associated with some short term distress for the child and the family.2 However, most children in the study were reported as being happy and had normal behavioural scores. We have recently reported results from a birth cohort study suggesting that longer term psychosocial sequelae may be associated with patching treatment (the Avon Longitudinal Study of Parents and Children, ALSPAC3). A history of patching treatment and wearing glasses were both independent risk factors for children reporting that they had been bullied in the past at age 8.4 Repeated bullying victimisation is consistently associated with physical and emotional problems for the victims and may have long term adverse consequences.5, …