This optical management may be used for excess convergence at near—that is, an esodeviation greater at near. Underplussed or overminused spectacles create the need for greater-than-normal accommodation. This excess accommodation creates more accommodati

accommodative and vergence dysfunction is shown in Appendix Figure 2. 1. Accommodative Dysfunction This Guideline uses the Duke-Elder classification of accommodative dysfunction.14 a. Accommodative Insufficiency Accommodative insufficiency occurs when the

Patients with convergence insufficiency often leverage accommodation to drive convergence. Performing this test with a penlight is important because it can tease out a receded NPC. 2,3 Patients with “pseudo-CI” accommodative insufficiency (AI) will sh