Why are some children with esotropia on bifocals? Do they ever get off bifocals?
Children with accommodative esotropia are not a homogenous group of patients. The ones who benefit from bifocals are those with high accommodative convergence/accommodation ratio. This subset of patients exerts excessive convergence when focusing on objects at near. The bifocals help straighten their eyes by decreasing the degree of accommodation at near. The power of the bifocal adds are gradually tapered after 7 years of age.
