Spectacle correction is the initial treatment for accommodative esotropes. Generally, the full cycloplegic correction should be given initially. This can be decreased over time to as long as orthophoria is maintained. Single vision spectacles are used in most cases and have been shown to control the esotropia in two-thirds of cases.[1] Bifocals can be used if the distance fixation is orthophoric but there is more than 10 prism diopters of esotropia at near fixation. The minimum bifocal power that restores normal ocular alignment at near (up to 3.5 diopters) is recommended.
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