Accommodation/Vergence Dysfunction Cheat Sheet by lbb

Low accomm­odative amplitude

Low AC/A

High Lag

Fails -2.00 (OD, OS, OU)

Low PRA

Eso at near

High AC/A

Low Lag (or lead)

Fails +2.00 (OD, OS, OU)

Low NRA

Eso at near

Fails/­dif­ficulty +2.00 & -2.00 (OD, OS, OU)

Low NRA & PRA

Eso similar dist & near

Reduced BI (dist & near)

Eso fd (dist & near)

Normal AC/A

Large Lag

Low PRA

Fail -2.00 OU

Near Eso > Dist Eso high tonic vergence

^Near Eso, Dist Ortho normal tonic vergence

Reduced NBI (DBI may be reduced), BI facility (near)

Eso fd

Moderate hyperopia

High AC/A

High Lag

Low PRA

Diffic­ult­y/fails -2.00 OU

Near Exo > Dist Exo low tonic vergence

Dist Ortho, Near Exo normal tonic vergence

Reduced NPC

Reduced NBO and BO facility

Low AC/A

Small lag (or plano)

Low NRA

Difficulty +2.00 OU

Exo fd

Near Exo > Dist Exo

Receded NPC (noncom. & accom. target about the same)

Reduced PFV (or BO) at near

Reduced PRA

Fails -2.00 OU, Low OD, OS

Low amplitude

Large lag (>+­1.00)

Additional plus at near may reduced exo &/or improve NPC

Dist Eso > Near Eso high tonic vergence

Reduced DBI, BI facility (dist)

Eso fd at distance

Low AC/A

Dist Exo > Near Exo low tonic vergence (tropia or phoria)

Normal or limited DBI (adequate DBO)

High AC/A

Exo similar dist & near

Reduced BO (dist & near)

Possibly receded NPC

Redced BO facility (dist & near)

Exo fd (dist & near)

Normal AC/A

Small Lag

Low NRA

Fail +2.00 OU

Reduced BI & BO dist and near

Reduced vergence facility (BO &/or BI at DV &/or NV)

NRA & PRA may be low

May fail/d­iff­iculty binocular accomm. facility

Normal AC/A