Ill sustained accommodation is characterized by which pattern?

• A. Fatigues with repeated measures; amplitudes normal at first; may worsen; more likely eso posture
• B. Improves with repeated measures
• C. Not fatigable
• D. Is a form of myopia

Answer: (A)

Ill-sustained accommodation means the focusing system tires with continued near work. The key idea is that the accommodative response is normal at first, but with repeated or prolonged near tasks it fatigues and can no longer be maintained. This wear shows up as increasing blur and less accurate focusing on subsequent attempts, and the binocular system often shifts toward a near esophoric posture as the accommodation–vergence link struggles to keep alignment despite dwindling accommodative input. It’s a fatigable pattern that worsens with repeated measures, rather than something that improves with practice, is not non-fatigable, and is not simply a form of myopia.