Which sign is a hallmark of 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: (B)

Accommodative insufficiency is a condition where the eye can’t provide enough focusing power for near tasks. The most telling sign is a reduced amplitude of accommodation—the total dioptric range the eye can shift from distance to near. When AA is lower than what’s expected for the person’s age, it means the eye’s accommodative reserve is limited, so near work becomes blur-prone and the patient often has to pull print farther away or strain to see clearly. This reduced AA explains why near tasks are difficult and is the clearest, defining indicator of the problem.

Other signs can appear as a consequence of insufficient accommodation, such as a higher lag of accommodation on dynamic tests or trouble with accommodative facility, but these reflect the consequences of the limited available focusing power rather than being the fundamental deficit.