The primary care pediatric nurse practitioner performs a vision screen on a 4-month-old infant and notes the presence of convergence with mild esotropia of the left eye. What will the nurse practitioner do?

Choice A reason: While intermittent strabismus may be normal in infants under 2 months, persistent esotropia at 4 months is concerning. Reassurance alone is not appropriate at this age. Choice B reason: Patching is a treatment for amblyopia and may be used after a diagnosis is confirmed. It is not initiated without specialist evaluation and may be inappropriate if the underlying cause is not yet identified. Choice C reason: Rechecking in 2 to 4 weeks may delay necessary intervention. Early referral ensures timely diagnosis and management, which is critical for preventing amblyopia and ensuring proper binocular vision development. Choice D reason: Referral to a pediatric ophthalmologist is the best course of action. Persistent esotropia at 4 months requires expert evaluation to determine the need for corrective measures such as glasses, patching, or surgery.