Which finding would you expect in a pseudo-CI patient but NOT a true CI patient?

• A. Decreased amplitude of accommodation
• B. Near exophoria
• C. Low NRA
• D. Unable to clear plus on BAF

Answer: (A)

Pseudo-convergence insufficiency presents with similar symptoms to convergence insufficiency, but the underlying issue is a reduced accommodative amplitude rather than a true vergence deficit. Because accommodation and vergence interact through accommodative convergence, a smaller accommodative response lowers the amount of vergence support available for near tasks, producing CI-like symptoms even when the vergence system is normal. Therefore, the finding you’d expect in pseudo-CI is decreased amplitude of accommodation. In true CI, accommodation is typically within normal limits, and the diagnostic focus is on vergence weaknesses such as reduced near vergence ranges or an abnormal near point of convergence. Other signs, like near exophoria or parts of accommodative testing (e.g., NRA or BAF results), can occur in various binocular vision conditions and don’t specifically distinguish pseudo-CI from true CI.