Plus lenses to help with NPC are expected in which condition?

• A. Convergence insufficiency
• B. Pseudo-convergence insufficiency
• C. Divergence insufficiency
• D. Accommodative esotropia

Answer: (B)

Plus lenses at near reduce the accommodative demand, which in turn lowers accommodative convergence. In pseudo-convergence insufficiency, the near alignment problems stem from uncorrected hyperopia and excessive accommodative effort; correcting that with plus lenses lessens the need for convergence and often improves the NPC, bringing the near point closer. This is why NPC improvement with plus lenses points toward pseudo-convergence insufficiency. In true convergence insufficiency, the core issue is vergence control, so NPC typically does not show the same improvement with plus lenses.