Patching vs Atropine Drops

Since we have patched for many months and struggled with keeping it on daily, our PO recommended Aptropine drops.  The Atropine blurs the near vision in the better-seeing eye and has statistically shown the same improvements in Amblyopia patients.  The Pros of the drops is that the children do not have an option to take them off and therefore receive the necessary time strengthening their good eye, The Con is that is a chemical that stings upon placement in the eye.  In our hand-out is says “In some children, it is necessary for one adult to hold the child while the other gives the drop.”  Others have compared the feeling to how Chlorine would feel if put in your eyes. 


I was very nervous about putting eye drops in.  We would rather patch, but Elly is so stubborn and opinionated that unless she made the choice to keep them on, we would not be able to patch 6 hours a day every day.  My husband and I talked and we decided to be honest and tell Elliana simply what was happening.  Her eye is not working and we need to make it stronger.  We then gave her a choice. “Do you want to wear a patch all day or put eye drops that hurt in?”  She choose Eye Drops.


So, we had her gather her animals and dolly to squeeze, laid her down on the bed and warned her that it will hurt, but that it will be ok soon.  My dear husband put the eye drops in and we waited.  Elly pointed to her other eye and said. “Put the drops in this eye too.”  Ha ha ha – no, only one eye necessary. About 1 minute later, she said “owie, owie, owie” and tried to rub her eyes, but that was it.


I’ve noticed her coordination is off, just like when we patched.  We do rice pouring often and have never spilled any on the floor.  Today there was rice everywhere.  She also seems to loose her balance when she is walking and ran into a couple things already this morning.  So that must mean the drop is working.


I still worry (Yes, I am a worrier!) And we will ask her again tomorrow morning which she would like.  For now, the drops seam to be the better choice for us.


Did anyone else have this choice?  What helped you make the decision? How did your child react?

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37 thoughts on “Patching vs Atropine Drops”

  1. Update- Eye drops are going much easier than expected. She was a little more light sensitive than usual, so we are trying to find clip-on sunglasses. Any one find a good brand that is light and stays on?

  2. We had the patch/atropine debate as well. Our little Z would not keep the patch on (or her glasses, for that matter), so we tried drops for a while. They seemed to help a bit, enough that after a couple of months we were able to stop the drops and replace with a shorter patch time. The eye doc feels good about her progress.

    One thing that our pharmacist told us about the drops (but the eye doc didn’t) is that some kids get a bit hyper from the drops (their heart races for a time, too). So we were advised to apply them in the morning, not at night. I did notice very rapid heartrate for our daughter the first few times, but I thought it was because she had just been held down and the adrenaline was pumping. Not so, apparently.

    Anyway, just thought I’d let you know, in case you experience that, too.

  3. Tobi – Thanks for the info. I had no idea, but was told to put them in first thing in the morning because they are only active at blurring the vision for the first 6 hours of use even though the pupil is still dilated for much longer. She has been a little more active than normal; but she is a very high energy child to begin with and I just assumed it was the holidays. We’ll continue to keep a close watch on her! She did choose a patch this morning, only to keep in on a whole 2 minutes and then take it off and tell me she wanted the eye drops. In just the last week, I have seen a huge improvement in her lazy eye, so I am hoping the drops and glasses combination is working at strengthening her right eye!

  4. Hello, my daughter Mia was diagnosed with a unilateral cataract when she was 12 days old and she also developed glaucoma and nystagmus soon after her cataract surgery. She currently wears glasses and we also have to patch her left eye to help force her right to see. We have a very difficult time with her glasses and patching since she began wearing both at 2 months old. My daughter is now 7 months old and we are trying a few more options before she will mostly likely be wearing a black contact lens that will occlude her eye just like a patch. If you are having as much problems as we are, you should discuss the black contact lens with your PO. Mia also had to have atropine drops placed in her eye 2 times a day for several months to help widen her pupil (her pupil if fixated in one position). Her PO wanted her pupil open as wide as possible to allow more light into her eye. I did not notice a change in her behavior while she was on the drops, however she is still very young. Once Mia gets the black contact lens I will post a message on this blog to let other parents know how well it works.


    1. Hello Danielle, I know your post is back from 2009, but I was wondering how your daughter was now?? Can she see ok?? Are you still patching??
      I ask because my son had a cataract removed 3weeks ago today (he is 3 next month) and a new lens implanted, we have started patching few days ago and have chosen his glasses, so any day will be collecting them.
      Its very scary time for him and for us he dealing well with the patches so far, I know that we have long journey ahead, and have never heard of anyone else child having a catarct as such a young age, (which is why I have contacted you) it wasn’t picked up till he was 2years old when I noticed a slight turn in his eye any advice would be grateful, thanks Naomi x

  5. hi, my name is nancy. i have a former 29 week premiee who is 15 months now. he too has been diagnosed with amblyopia on his left eye. we’ve tried patching and that seems impossible. we went back to the doc and he prescriped the eye drops. my spouse and i are very hesitant about using the eye drops. we’re afraid that later down the road the eye drops would affect his good eye (right). can anyone share suggestions, input, experiences? he’s our first son and are new to the parent/preemie situation. thanks!

  6. We’ve now been using the eye drops about 75% of the time for the past month. In addition to re-assurances from the OP that they will not affect her good eye, I Googled information about Atrophine drops and the studies support this as well. Additionally, I contacted the vision outreach services, a division of our states school of the deaf and blind. The parent advisor said that the treatment plan was typical and that she expects her vision will improve dramatically over the next several years. It makes me a little less wary of the drops since all 3 places are all saying the same thing. Patches are better, as the children can still see with drops. But, for some children (like mine) it is better to use drops than fight about patching 24/7.

    Oh – and in the past 4 weeks, her vision in her right eye has almost doubled =) =) =)

  7. amomofelly,

    thank you so much for sharing your experience with me. you really don’t know how much i truly appreciate it! :) i will relay the information to my spouse and will start using the eye drops immediately. will continue to post regarding progess. again….thank you for guardian angels like you……….be blessed!

  8. amomofelly, my 5yo son was just diagnosed w/amblyopia yesterday & as soon as we have his new glasses (hope this weekend) we will begin with atropine drop therapy. I thank you so much for sharing, I haven’t stopped crying since yesterday & reading this thread has made me feel better. I work full-time & am a single parent, my son is in preschool all day. How many days did it take Elly to not bump into things? I just don’t know how much time to take off to be home with him while we begin treatment and when I can bring him to preschool/daycare again. Any advice is most welcome.

  9. Kari, hang in there. It took ME longer than my daughter to adjust. I heard 7 is the magic age, so you are SO lucky to catch it now and have the chance to help him regain vision. Elly was only 2 when we started, so really didn’t understand. Your son at 5 will be able to understand when you explain that the eye drops hurt when you put them in, but that it is an excercise so your other eye will get stronger. Our PO had us wear just the glasses for a couple weeks. The advice section has great tips on keeping them on. Then we started eyedrops. She was off and running. My advise. Maybe take one day off just to make sure he doesn’t have an alergic reaction. Keep us updated. We’ll be thinking about you!

  10. Wow… I can’t believe it! We have a daughter named Elliana (When I named her that, I had never seen it spelled that way before… “my God has answered me.”) and we call her Ellie. She was born with strabismus, and we have patched since she is two months old. She had eye muscle surgery at 9 months, and it straightened one eye, but the left eye went back towards her nose. She got glasses and we are patching ever since (almost two years since). Today, we were at the eye doctor and he is recommending eye drops again.. which we had tried before but she was so whiney, I was afraid something was wrong, so she got off of it. She does fine keeping the patch on, but the doc still thinks she would benefit from the drops, which is why I was searching the web… and I found this post…. It has to be a small world. :-)

  11. I was wondering is your daughter taking the 1% atropine drops? When we tried this the first time about a year ago, the eye doctor prescribed the 1/2% drops, but when I went to get the prescription filled, they could only order the 1% drops. They apparently called the eye doctor, who said to go ahead with the 1% drops. I worry, especially after reading all the possible side effects :-(, so when her personality changed so much while giving these to her, I called the eye doctor and was finally told to take her off of it. Did you experience anything like that? Her eye stayed dilated for over two weeks after taking her off of it. I also heard that people with light colored eyes (Ellie’s are blue) dilate more easily than people with darker colors. I guess because she has strabismus in the left eye, which makes her have amblyopia, it causes that left eye to wiggle back and forth rather than stay straight, so the doc thinks that maybe the atropine drops would work better in correcting the wiggle to fix that eye. What do I know? I guess, I have to take their word for it? :-) We are patching six hours a day. She hardly ever gives me a problem with it. We have both the patch that attaches to her eye and the sticky patch. By the way, I found a new company that makes these patches and you can get your kids to pick their own design. I’d be glad to share the website. Anyways, we have been at the eye doctor every two months for over two years now and there has not been much improvement, so I am ready to make some progress. We are also going to start vision therapy if our insurance company approves it. Does anyone have any experience with that? Thanks for your comments.

  12. I’m so happy your kids are keeping their patches on!!!! Our PO said that patching would be the best, and she did for about a year. When she turned 2 and got glasses we took a break from patching. We re-introduced patching, but after going through a box of 50 in 3 days, several times, we ended up switching to full time atrophine drops. She is really good at scrunching, eating, flushing and even getting her scizzors to cut the patch so we can’t put it back on. I just checked and her drops are 1%, her eyes do stay dialated for 2 weeks, she is light sensitive, and we did notice a severe change in behavior at first (I will post about this soon) I’d love the website for patches, we found Ortopad works the best so far.

  13. Now, I won’t say that tomorrow, Ellie won’t give me a hard time with her patch. :-) She does always ask me to put it on her other eye, but then she laughs, knowing I am not that easily tricked, although I have four children under the age of four and our house can be a mad house at times. :-) Now, eating the patch that’s a trick she hasn’t tried yet. Anyways, the patch website is I have to say that I have not tried these as I just found it and had just finished ordering some more patches from ortopad… they had buy one get one free on the junior size brown patches. I figure, I don’t care what color they are, if I can get them for half the price. :0 But it looked like a patch I would like to try if we don’t end up doing the drops…

  14. My 3.5 year old daughter has Amblyopia and her doctor prescribed the following:

    one drop atropine every morning
    a patch for two hours every day
    a plain glass in her glasses on her good eye even though she needs a +275 on it the lazy eye glass got the right prescription

    She doesn’t seem to mind the atropine once it is put in. We call it lenses and she is proud to have lenses like her mom. The patch seems to bother her more and she starts asking when I will remove it after wearing it an hour.

    I am glad to read that atropine is fine because it has made me very uneasy to put a drug in her eyes especially with the dilated pupil.

    But I still hope that when we return to the doctor after three weeks he will stop the atropine.

  15. I just found out my son had Amblyopia, and his dad and I are concerned because he will not wear his glasses. He is 4. I’m also upset that his doctors didn’t catch this before when they did the eye exams and so on. I feel bad that it’s taken us this long to know about it whne we could of started his treatments when he was younger. We always noticed him squinting or being sensitive to the light but his pediatrician didn’t commnet on it any further.
    Finally after making his last yearly visit and I brought it up gain is when they send me to the opthomologist. The PO did recommend glasses first and than in three months the drops and patching, but everyone on here seems to be doing the drops right away.
    Should I enforce that issue with his OP since he refuses to wear glasses. I though once we got the glasses he would leave them on since he could see better but that isn’t the case?
    I’m so confused and having been searching the web for answers. I’m so glad I found this site. Both my husband and I have great vision and our older daughter so we were shocked to no avil that our lil son had this vision problem.
    Has anyone researched surgeries for children and has anyone had any success with it?
    Will his eye ever get better? what site is good for ordering glasses? it was an ordeal just to shop around the eyewear stores just to find out that didn’t have much of a selection on his size. We need some sport glasses and sunglasses of some sort for him since he does sports and alot of outdoor activities. Thank you. any responses would help this desperate mom trying to find some answers from real parents not just OPs and websites. Thank you

  16. Hi Mamas, I can understand your frustrations, and I’m glad you found us here. I hope I can give some answers, I’m also including a lot of links to other pages I’ve found to be helpful.

    You will want to check out the blog Amblyopia Kids ( for more support in dealing with Amblyopia – I think MT’s daughter is the same age as your son. The good news is that glasses and patching can work. Depending on what his prescription is now, he may only need glasses, but I’ve usually heard that patching or drops were required. I would ask your PO why he or she recommends waiting on the patching. Also, check out the Prevent Blindness America forums – there are a lot of parents there posting about amblyopia

    I think the patching won’t work though, without his also wearing glasses. You can check out our Collected Wisdom page for some tips, and I’ve found this page – has good advice, too. Let us know how it goes, and good luck. I know it’s hard to get them to wear the glasses at first. Everyone loves to say that kids will wear glasses if they help them see, but it’s often not that easy, especially at first.

    In regards to surgeries – my daughter had eye muscle surgery this past August. My daughter has strabismus due to farsightedness, but not amblyopia. That surgery is only recommended for children with crossed eyes, that aren’t fixed with glasses. It does not help with Amblyopia, but if the amblyopia is caused in part by eyes not being straight, then it would make sense to pursue it. I would definitely recommend trying glasses and patching first.

    I know a couple of parents here have ordered successfully through Zenni Optical, though it can take a couple of weeks to get the glasses. There are a couple of other vendors listed here I also know that people have had good luck with Target and Costco optical stores, if either of those are near you. Sadly though, unless you’re lucky enough to live near an eyeglasses store specifically for children, you won’t find much of a selection for young kids.

    Good luck to you. I hope you stay in touch and update us on how things are going. We’d love to post a picture of your son in our photo gallery if you’re open to that.

  17. Wow, I wish I’d have found this site before I did 4 hours of Googling! We’ve been doing the drops for 4 weeks now, doc said to do a drop every 4 days instead of 6 because he’s still slightly contracting. His 6 week check yesterday (from diagnosis) went WONDERFUL! He’s reading 3 lines higher (from 20/50 to 20/30-35) on the chart already & she’s thinking he’ll be up to 20/20 w/in the next couple of months. YAY!
    I was hesitant about the drops, mostly because I know Atropine is a paralyzing thing & that just doesn’t sound good. I literally searched 10 pages of Google results w/different search terms & found ONE study that had long-term effects listed. It said w/long-term use (didn’t specify how long though) there’s a chance that the good eye can become “lazy”. I figure since he’ll only need them for a few months & we’re not dropping daily, he’ll be good. Patching is not an option-he’s too active & would be pulling it off after 15 mins. He wanted to do a pirate patch but I just don’t see him keeping it on for all day, every day.
    We’ve had no behavior changes w/the drops. I do them at night (just 1 drop actually) just before he goes to sleep-they recommended that since it burns for a bit, to just drop, let him blink it in & then fall asleep so he doesn’t think about the burn.

  18. It’s great to hear words of encouragement from “real” people not just the OPs but now I’m wondering why our doc ordered us to only use drops on the weekends and not daily like most others. Especially because my son has such a severe case and is already five.

  19. I think it is a good question and would recomend calling your PO. Thats why they are there =) I have called many times with questions that come up or I forgot to ask at appointments. We had to put drops in every morning because as I was explained, although their eyes stay dialated, their vision is only weakend for 5-6 hours after they are applied. (just a parents understanding – please also ask for clarification from your PO) Also, our PO had us start with patching because it is full occlusion. It was such a fight that we tried atropine drops. Her vision did not improve and she was still seeing 20/40 in her good eye several hours after drops. We ended up going back to patching (12 hours each day) and have seen much improvement =)

  20. Hi, Just needed some advice really. Our 5 year old has amblyopia in her left eye, visions pretty bad in both but left eye is extremely poor. Weve been patching for about 2 years now, including patching all day every day for the last 10 weeks, with no improvement :( Our opthamologist has recommended that we now stop patching as it has started affecting the vision in her good eye and has suggested that we could try atropine drops as a ‘last resort’. He has stated that the drops are not as normally as effective as the patching because of the partial occulusion rather than the full with the patch. I’m unsure as to whether to do the drops or not..patching her has never been an issue (luckily!) but we haven’t had any success with this, even on the maximum time, so do we try the drops as a ‘last resort’, and put her through the stress of them (she’s a nightmare with them at eye exams etc..) or do we just accept that there’s nothing else that can be done?! Any advice greatly appreciated :)

    1. Carly, there are plenty of things that can be done or at least tried, most likely withing the context of vision therapy. Have you consulted with a developmental optometrist? See what they say. I recommend reading “Jillian’s Story” for some insights and inspiration.

    2. This is my exact situation with my 5 yr old. Patching never a problem, have been doing 8 hrs a day, no improvement, doctor recommends stopping the patching and could try drops as last resort. Carly – did you try the drops? Did it help? Were they as bad/painful to put in as the ones in the doctor’s office? Would really love to hear. I’ve never posted on a site before, but found this as my exact situation. Thanks for any insight.

  21. My daughter Emma is 4 yrs old and we were told about 7 months ago her right eye vision is 20/200. We have been doing the glasses which didn’t help at all. Her Doc has now given us patches which I must say is a battle. She refuses to wear it and crys all the time when she does. She has shown signs of depression as she crys and crys. I feel terrible as no mother wants to see her child upset. I want to do the drops but of course I know they will hurt and I’m afraid she will get more upset. She’s normally a happy cheerful fun loving little girl and now she has become shy,distant,and unhappy. I’m torn on what to do. Anybody else run into this problem???

  22. Cara, hang in there. I know that this is rough. We ended up going back to patching (full time) after trying atropine and I agree that it is not fun for our kids. I have some girl patches that my daughter has outgrown and they are left eyes – Would Emma like getting some in the mail? If so, my daughter can send her some! May not help every day, but it is nice to know that there are other little girls out there patching =) Just send me your address and I will stick them in the mail! ajrenchin at yahoo dot com.

    1. It is so hard. I keep telling her if she doesn’t wear the patch we will have to do the drops and of course she says No. She has gotten to the point where she hates her glasses before patching she loved them. Maybe her getting some patches from another little girl will help her. If you give me your email I’ll send you my address. Don’t want it public. It’s so nice to have a place to see other people going through the same problems. At least we are not the only ones going through it!

  23. THANK u ALL!!! I Feel so blessed to have found this site! I was so worried about the drops and now I feel much better about using them.We are getting her glasses on Tues and starting the drops as well.Our Emily is 2 and she doesnt understand whats going on patches are NOT an option she is so strong that we knew the drops had to be the way to go.Wish me luck everyone as our journey begins next week.Thank U all again and god bless everyone and theyre kids!

  24. Hi! My son Hayden is 16 months old and we have been going to eye doctors at Duke since he was 1 month old. He has a rare mass behind his left eye that has not been diagnosed yet, they are possibly thinking it may be a lymphangioma but there has been no clear diagnosis because it doesn’t meet the standard criteria for anything. He also has amblyopia in his left eye from the bulging from the mass. He has had multiple eye glasses prescriptions and we have even been to Cincinnati for a second opinion. He was wearing a patch and wearing his glasses up to about 5 months ago and then he began pulling them off and now he refuses to wear either. The doctor in Cincinnati recommended atropine drops but our doctor here at Duke would not prescribe it because she did not agree, now she has prescribed the prescription 4 months later (his vision has since got worse) but also changed his eye glasses prescription to match or make up the blurring in the right eye that will be occurring from the atropine drops. Has anyone ever heard of a doctor doing this??? Nothing is wrong with his right eye and we are not sure if this seems like a good idea, by putting a prescription on a good eye. Any advice or suggestions would be greatly appreciated!!!

  25. Wow – sounds like your little one is a trooper! I’ve heard of the perscription change to make the eye blurrier, but don’t have any research or have not experienced it personally – sorry I am not much help. Did you ask to see the current research to support this? My PO is more than happy to support her recommendations with research. I’d call and ask them to provide more info or ask what the short term / long term effects this may have on his stronger eye. We did try a prism that they stuck to the lenses of the good eye to do what seems like a similar thing – blur the vision in the good eye (in addition to patching and atropine drops) Wishing you both the best of luck!!!

  26. Hi. I’m so glad to have found you all! I have a sweet, smart, charming, easy-going little girl that seems to be really struggling with the atropine eye drops. She is nearly 2.5 years and had eye surgery 3 months ago to correct a turn in. She hates patching and I’m lucky to get 15 minutes from her. This is our second try at the eye drops and both rimes she turns into a bad little girl who is terrified of silly things (monsters/things she can’t see properly), terrified of the dark or just dimly lit rooms, scared to go to sleep (we used to just tuck her in and leave). I stopped using the drops but she isn’t acting her normal self yet. I miss my good girl. We’re going back to the dr in 2 weeks but I’ve got to try harder at patching I guess. This is so tough! :(

  27. Hello everyone. I am so very glad that I read all of these blogs. My son just turned 3. He was born preemie and has amblyopia we have been doing patching for 2 months and our OP told us that we need to go to atrophine drops. I cried like a baby bc its just so hard to see your child not be perfect like you want them to be. I was really going to just not use his advice but after reading everyones accounts I feel better about atleast trying the drops and seeing what happens. Thanks for all the great stories.

    1. I cried as well! Its very difficult to find out something is wrong expecially considering I do not wear glasses nor does my husband..Yet we have to put our baby through this… My daughter was 6 months old when she got her glasses… she is 14 months now and we are working on a new plan… the last didn’t work! Atropine and a new RX for her glasses! Wish us LUCK!

  28. Hello all- My daughter Lillian is five. We have had her glasses for two years and have been patching off and on 4-6 hours a day for the past two years. She had a great initial success with vision improvement in her bad eye but now it seems to have plateaued. Bc I’m only an ok mom I was not that consistent and because she will be in kindergarten in the fall, our doc recommended the drops. I started them a week ago and over the last three days, my daughter has been complaining that her stomach hurts at bedtime. She has been crying and saying she ate too much. Has anyone had this experience? Thanks for the info and the support.

  29. I just came across your post. I have to do this to my son. He cheats with th patch on. It’s one that goes on glasses because he hates the bandaid like one. He pulls the glasses down a tiny bit n looks threw with good eye which I’m afraid might make his good eye get worse. He is afraid of the drops. Seeing that your post is old I wanted to see what the outcome was. Did doing the drops or patch improve the vision of her eye?

    1. Honestly……The Drops were more torture then it did any help. The Doctor even said so. Patching, well it worked part of the time. I did it for only 30min a day if we were lucky and I made her wear the stick patch for that time so she couldn’t cheat. This is what helped for my daughter……I had a special coloring book for only patch time. I made her color a page with eh patch on and sometimes two pages. As time went on we started to notice the improvement. Her vision at the time was 20/300 and she has improved to a 20/50. You just need to stand up and make him do it but make it fun. When he is done the whole book tell him he will get a movie out or another special thing. So far it has been a crazy ride but it’s all for the best and we are seeing improvement. I wish you and your son the very best

  30. After reading a little bit of this blog and some replies I am relieved that we are not the only ones dealing with this. My daughter was dianosed at 6 months with Amblyopia in her left eye. We had an RX for a pair of glasses that blurred her good eye and made the “bad” eye work but the glasses were not working for us she would take them off after two seconds of putting them back on her.. after many reviews and decided to switch her rx and using the atropine drops we are also purchasing the Miraflex glasses in hopes for better luck! I am not sure exactly what my daughters vision is but he refers to it as dollars. (325 in one eye and 750 in the other) Have not an idea what that means?! Nor do I know if she is far sided or near sided! :( I do not get along with her doctor but know that he is the best in the area. He doesn’t tell me what is going on just what the plan is… I hate that! Please if any one has any answers for me please feel free to respond! Looking out for others to help me!

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