The timing of patching treatment and a child’s wellbeing

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, …