In a mildly amblyopic anisometrope with a high AC/A ratio, esotropia was corrected by prescribing maximum plus lenses. By altering spectacle lens parameters and reducing the diameter of the spectacle lenses, aniseikonia was reduced while maintaining cosmetic acceptability. The vertical imbalance was partially compensated without the need for bicentric grinding by leaving the patient with a small left hyperphoria in the primary position and a slight right hyperphoria at the near visual point.
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