Which is the LEAST likely finding in a patient with Accommodative Insufficiency?

• A. Reduced PRA
• B. Reduced Amplitude of Accommodation
• C. Inability to Clear Plus Lenses on MAF and BAF
• D. High Lag on MEM

Answer: (C)

Accommodative insufficiency means the eye’s ability to bring near objects into focus is weaker than expected for age. You’ll see a reduced amplitude of accommodation, and the system often cannot generate enough accommodation when demand is increased, which shows up as a high lag on MEM. There’s also typically a reduced ability to increase accommodation when asked (lower PRA).

Plus lenses in accommodative facility tests reduce the demand on accommodation; a patient with accommodative insufficiency would generally still be able to clear targets through plus lenses because those lenses lessen the need to accommodate. In contrast, clearing tasks that require more accommodation (like minus lenses) would be more challenging. Therefore, the statement about being unable to clear plus lenses on MAF and BAF is the least likely finding.