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65) and were no more likely to require surgery ( = 0.13). Among this cohort of children with accommodative esotropia and a high AC/A ratio, bifocal use was discontinued in the majority of children within 10 years, and more commonly among those who underwent strabismus surgery. The use of bifocals was not associated with a higher likelihood of undergoing surgery or enhanced stereopsis compared to those who did not use them. Among this cohort of children with accommodative esotropia and a high AC/A ratio, bifocal use was discontinued in