AIM: To analyze the clinical application of calculated and gradient accommodative convergence/accommodation ratio(AC/A)in different eye positions.

METHODS: A total of 127 myopes in ophthalmology were included. The calculated AC/A was obtained by near/distance phoria and the gradient AC/A was obtained by near addition +1.00D. The differences of eye positions of the calculated and gradient AC/A were compared.

RESULTS:The calculated AC/A value was higher than the near +1.00D gradient AC/C(P<0.01); Comparing the same method in different eye positions revealed that the calculated AC/A and gradient AC/A were significantly different, which has the highest AC/A in the esophoria group and the lowest AC/A in the exophoria group; Comparing the two methods in the same group revealed that the calculated AC/A in the esophoria group and the normal group was higher than the gradient AC/A(P<0.01), and there was no significant difference in the AC/A measured by the two methods in the exophoria group(P>0.05).

CONCLUSION: The calculated AC/A is higher than the gradient AC/A, especially in patients with esophoria and emmetropia, it is easy to obtain high AC/A values by using the calculation method, resulting in erroneous diagnosis. The gradient method is more recommended.