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Your 5 year old patient presents with 10 prism diopters of esophoria at distance and 20 prism diopters of intermittent esotropia at near. The refractive error is +1.00 OD and OS and the child has 20/.20 visual acuity in both eyes with the glasses. With the glasses the cover test is ortho at distance and 10 esophoria at near. The best diagnosis for this patient is:
Accommodative esophoria or excessive convergence
Why high ac/a ratio I calculated 4 with out app patient