# Real-World Views of Patching Differ to Health Professionals’: An Online Survey of Professionals, Patients, Teachers, Parents and Carers

## TL;DR

A survey reveals differences in views on patching therapy for lazy eye among patients, parents, and professionals, highlighting barriers like bullying and adherence issues.

## Contribution

The study provides real-world insights into patching therapy challenges through a collaborative survey with diverse stakeholders.

## Key findings

- Health professionals prefer weekday and school patching, while past patients favor weekend patching.
- Past patients reported being made fun of as a major barrier to patching therapy.
- Health professionals and parents differ significantly from patients in preferred techniques for encouraging patching.

## Abstract

Patching therapy is the most common treatment for amblyopia (lazy eye) and is unsuccessful for approximately 40% of patients, leaving them with life-long unilateral visual impairment and increased risk of bilateral visual impairment later in life. Poor adherence to patching therapy is a major contributing factor in treatment failure yet we lack real-world understanding as to why this is a problem outside of controlled research studies.

In collaboration with patient contributors, we developed an online survey for past patients, parents/carers of children with amblyopia, health professionals, and schoolteachers. The survey included questions about when and where is best for children to wear the patch, the design of the patch, and facilitators and barriers to patching therapy.

We received 631 responses to the survey (259 health professionals, 213 parents/carers, 110 people who patched as a child, 7 teachers, and 42 people matched to multiple categories). Healthcare professionals thought weekday (54.4% versus 14.3% preferring weekend and 31.3% no difference) and school (54.4% versus 21.6% preferred home and 23.9% no difference) patching was more successful. Past patients (52.4%) favoured ‘force’ as a technique to encourage patching; more than both health professionals (7.7%) and parents or carers (19.7%). Patients rated ‘people making fun’ of them as an important barrier to patching.

We describe surprising differences in stakeholders’ responses to the survey questions about barriers to successful patching treatment. We suggest these differences are used as a guide for further work to explore stakeholder’s social experience of patching.