Which finding is NOT typically associated with Divergence Insufficiency?

• A. Greater esophoria at distance than near
• B. Low AC/A
• C. Non-comitant eso deviation
• D. Reduced NFV at distance

Answer: (C)

Divergence insufficiency is a problem with the eyes’ ability to diverge, so the misalignment is a exodeviation that is worse at distance than at near. The vergence system fails to provide enough divergence, and you often see reduced negative fusional vergence at distance, sometimes with a low or normal AC/A ratio. The pattern is typically fairly consistent across gaze directions, meaning it’s mostly a comitant deviation.

A non-comitant eso deviation would imply the inward turn changes with gaze or direction, pointing to another motor issue (such as a palsy or restrictive problem) rather than a pure divergence insufficiency. That makes non-comitant eso deviation the finding that doesn’t fit the usual DI profile, hence it’s not typically associated. The remaining findings align with the DI pattern: distance exodeviation, reduced NFV at distance, and often low or normal AC/A.