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Reflex Sympathetic Dystrophy (RSD) (CRPS) board

Here's some articles I found regarding RSD and your eyes. It really sucks.

Reflex Sympathetic Dystrophy Syndrome is a progressive disease of the Autonomic Nervous System that can follow a simple trauma (fall or sprain) a break or fracture (especially wrist and ankle) a sharp force injury (such as a knife or bullet wound), heart problems, infections, surgery, RSI/CTS, spinal injuries/disorders, or major trauma. It is a multi-symptom condition affecting one, two, or sometimes even all four of the extremities. It can also be in the face, shoulders, back, eyes, and other areas as well. It may spread from one part of the body to another regardless of where the original injury occurred; and RSD can spread in up to 70% of the cases. In a small number of cases it can become Systemic or body-wide. RSDS is an involvement of nerves, skin, muscles, blood vessels (causing constriction and pain) as well as bones.
ANYONE can get RSDS. There are now an estimated SEVEN MILLION Women, Men, and Children across the United States with this disease. It affects women many more times than men, maybe as high as four or five to one, and affects all age groups from 3 to 103.

Eye Complications in CRPS;

Dear Dr. Hooshmand,
Over t he last year I have developed watering eyes and my left eye turns outwards with double vision. Can this problem be related to my CRPS/RSD?

Dear SJ,
Many thanks for your e-mail letter. You suffer from 2 well-known complications of CRPS.

1. Keratitis Sicca which is due to CRPS at early stage causing pain and irritation in the eye with secondary excessive secretion tears. As the condition becomes chronic, the tear glands become exhausted, causing "dry eye" ( Keratitis Sicca). You need to use artificial tears every 2-3 hours while you are awake. Also, halfway during the sleep hours(approximately 3 hours after you are asleep), you should set the alarm clock to treat the eyes with artificial tears in liquid or viscous form.

2. You described deviation of the left eye sideways as well as double vision, and poor equilibrium. These are typical signs of poor circulation to the brain stem causing disturbance of focusing, and partial paresis of the eyes, and poor balance and falling attacks.

Treatment for the above consists of cervical epidural blocks containing Depo-MedrolĀ®, cervical paravertebral blocks followed by cervical massage to neutralize and to disseminate the irritative chemicals, e.g., substance P (pain substance which is identical to the chemical irritant Capsaicin), CGRP, and nitric oxide to peripheral blood circulation, and eventual excretion of these chemicals. Otherwise, you are at the risk of developing a major stroke.

With many thanks,

H. Hooshmand, M.D.

Visual And Hearing Problems:

RSD patients frequently develop blurring of vision, reading difficulty, problem with focusing, dizziness in the form of vertiginous attacks (either the body or the objects moving around). As well as hearing problems such as buzzing in the ear (tinnitus).

It is immaterial which part of the body has had the damage causing RSD. As the enclosed figure shows, the sympathetic nervous system is intermingled and connected through sympathetic ganglia which are on each side of the vertebrae from lower cervical spine region all the way down to the tail bone. This chain of sympathetic connections causes the spread of RSD to symptoms and signs both across the midline to the opposite side (from hand to hand or from foot to foot) and vertically up and down the spine. As a result, the patient may have RSD due to a knee injury or injury to the foot or hand and yet may develop stimulation and abnormal function of the sympathetic system causing constriction of the blood vessels to the brain. When the blood vessels are constricted in the distribution of vertebral arteries in the cervical spine and in the distribution of the blood vessels providing circulation for the hearing center and brainstem, the patient develops attacks of dizziness, trouble with focusing with the eyes (due to brainstem dysfunction which has the responsibility of coordinating the eye movements), and buzzing in the ears(tinnitus).

Treatment with alpha blockers (such as Clonodine, Hytrin, etc.), as well as newer antidepressants such as Trazodone or Zoloft, provide excellent relief for the above symptoms (figure enclosed) and Muscle relaxants such as Baclofen and Trizanidine.

At times the original injury that has caused RSD may cause retinal detachment (damage to the retina of the eye) or bleeding of the eye. For this reason, the patient should have careful eye examination by an ophthalmologist as well.

H. Hooshmand, M.D.