This document describes how to test for the near point of accommodation (NPA) and near point of convergence (NPC). For NPA testing, the examiner places a near testing card at 16 inches from the patient's eye and moves it closer until the letters blur, recording the distance. This is repeated for each eye. For NPC testing, the examiner holds a target at 16 inches from the patient and moves it closer until the image doubles or one eye deviates, recording the distance from the nose. Both tests measure the closest point an image can remain clear and single.

1. Testing for NPA and NPC
By- Raju RATHORE

2. Testing for Near Point of Accommodation (NPA)
Testing for Near Point of Convergence (NPC)
1
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Testing for Near Point of Accommodation (NPA)
1. With the patient wearing full distance correction and with t
he left eye occluded,
place the near testing card at a distance of 16 inches (40 cm) f
rom the patient
and ask the patient to read the 20/40 line with the unocclude
d eye.
2. Move the test card slowly toward the patient as you ask th
e patient to state
when the letters have become blurred.
3. Record this distance in centimeters or inches (whichever yo
u are using).

4. 4. Repeat steps 1-3 for the other eye and record as described above.
5. The NPA is that point (in centimeters or inches) where the patient can no lon
-
ger bring the image into clear focus.

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Testing for Near Point of Convergence (NPC)
1. With the patient wearing appropriate correction and with neit
her eye occluded,
hold a target, such as a pencil tip, at a distance of approximately
16 inches (40
cm) from the patient and ask the patient to fixate on it.
2. Move the object slowly forward and ask the patient to tell you
when the object
doubles.

6. 3. Observe whether both eyes are converging.
4. Note the position at which the image doubles or one eye deviate
s away from the
fixation target. The NPC is that point where a single image can no l
onger be
maintained. Record the distance (in centimeters or inches) betwee
n that point
and the upper bridge of the nose at the midpoint between the eye
s.

7. Thank You
Raju Rathore
raju.rathore@itmuniversity.org