Which conditions are plus acceptors and should be RXed with plus before therapy?

• A. Ai and ill sustained accommodation
• B. AE and infacility
• C. Accommodative insufficiency and vergence
• D. Hyperopia and astigmatism

Answer: (A)

The idea being tested is using plus lenses to reduce the near accommodative demand for certain accommodative disorders before starting therapy. Accommodative insufficiency means the eye can’t sustain enough accommodation for near tasks, and ill-sustained accommodation means the ability fatigues quickly. In both situations, giving plus lenses lowers the amount of accommodation the system must exert, making it easier for the patient to perform near work and participate in initial therapy sessions. That preparatory step with plus helps stabilize focusing so vision-therapy activities can be more effective.

Hyperopia and astigmatism are refractive errors that are typically corrected to achieve clear vision, but the question targets conditions where plus lenses are specifically used to facilitate therapy by reducing accommodative load, which is most relevant to accommodative insufficiency and ill-sustained accommodation.