The main cause of accomodative esometropia is hypermetropia. The accommodation required to clarify an image blurred by the long sightedness is excessive, resulting in esotropia. Typically it is seen in children under three years of age, but may occur at any age.
Alternatively, or in addition, there may be a high accommodative convergence / convergence ration (AC/A), with greater deviation at near than at distance, and accompanied by hypermetropia.
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