A 45-year-old hyperope with an amplitude of accommodation of 4.00 D who wears a full cycloplegic correction of +5.00 DS is asked to read at 25 cm. Can the patient sustain this near task comfortably?

• A Yes, because the accommodative demand is only 2.00 D
• B No, because the near point is behind the retina in corrected hyperopes
• C Yes, because the accommodative demand is 4.00 D and equals the amplitude
• D No, because the accommodative demand exceeds the available amplitude ✓

Explanation

Accommodative demand = 1 / 0.25 m = 4.00 B. However, a corrected hyperope must also overcome their refractive error. The total demand for near vision includes both the distance correction and the near task. The patient's available amplitude is exactly 4.00 B, which is fully consumed by the near task alone with no reserve. Clinical convention reserves at least one-third of amplitude for sustained comfortable reading, so the patient cannot sustain the task.

Reference: AAO BCSC Section 3: Clinical Optics, 2023-2024 ed.

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Written and medically reviewed by the StethoPrep medical team.