Is there a place for ipsilesional eye patching in neglect rehabilitation?

Neglect behavior of experimental animals with unilateral posterior cortical lesions improves with the placement of a second lesion in the contralesional superior colliculus or in the intercollicular commissure. Given that the retinotectal fibers are mainly crossed, it has been speculated that ipsilesional eye patching, by depriving the contralesional superior colliculus of its main facilitatory visual input, might achieve similar results, and thus be used as a remediation maneuver in patients with neglect. From six patients with severe persistent neglect, only one showed an unequivocal beneficial effect from ipsilesional eye patching. We discuss the factors which possibly underlie success and failure with this procedure, and the place for it in neglect rehabilitation.