Patching for Diplopia Contraindicated in Patients with Brain Injury?

Area of Science:

• Neuroscience
• Ophthalmology
• Rehabilitation Medicine

Background:

• Monocular patching is a common treatment for double vision in acquired strabismus, particularly in head-trauma patients.
• Spatial neglect is a common neurological condition following brain injury, affecting spatial attention and awareness.

Purpose of the Study:

• To review the literature on spatial neglect.
• To discuss the potential effects of monocular occlusion on spatial attention in patients with brain injury.

Main Methods:

• Literature review on spatial neglect.
• Analysis of the effects of monocular occlusion on spatial attention.

Main Results:

• Patching the left eye can exacerbate spatial judgments in patients with left neglect.
• This worsening is linked to inhibition of the right superior colliculus, impairing contralateral leftward orienting (Sprague Effect).

Conclusions:

• Peripheral visual field, especially the temporal crescent, projects contralaterally to the superior colliculus.
• Avoiding patching of the temporal crescent is advised to mitigate negative effects on spatial attention.
• Taping spectacle lenses or using specific eye patches can achieve this targeted occlusion.