Which of the following is a visual therapy objective for accommodative excess?

• A. Develop feeling of divergence
• B. Improve accommodative amplitude
• C. Increase convergence
• D. Decrease fusion range

Answer: (A)

Accommodative excess occurs when the eye’s focusing response is stronger than needed, often pulling in too much convergence as part of the near reflex. Vision therapy for this condition focuses on relaxing the accommodative system and improving binocular coordination, especially by balancing the vergence system that accompanies accommodation. Developing a feeling of divergence helps the patient become more aware of outward eye movements and strengthens the ability to diverge when appropriate. This counteracts the reflex convergence that accompanies overactive accommodation, helping the eyes adopt a more relaxed alignment and easier focusing at distance and near.

Increasing accommodative amplitude would worsen the problem by making the overresponse even stronger. Increasing convergence would amplify the inward eye turning driven by the excess accommodation, exacerbating symptoms. Decreasing fusion range would reduce the patient’s ability to maintain single vision, which isn’t a therapeutic goal for this condition.