• Neera Kapoor, Kenneth J Ciuffreda, and Barry Tannen.
• Department of Clinical Sciences, State College of Optometry, State University of New York, New York 10036, USA. nkapoor@sunyopt.edu
• Clin J Pain. 2002 Mar 1; 18 (2): 93-8.

ObjectiveThe objective was to present new visual sensorimotor findings in a patient with complex regional pain syndrome type I, formerly known as reflex sympathetic dystrophy.DesignClinical measurements were compared for the following visual sensorimotor tasks before and after 10 minutes of near visual stimulation: accommodation, vergence, and reading eye movements.PatientThe patient was a 19-year-old female university student with complex regional pain syndrome type I.ResultsAll visual sensorimotor findings worsened dramatically after performance of the brief near visual task. In addition, the patient experienced severe dizziness, nausea, dull eye ache, and general fatigue, which persisted for 30 to 45 minutes following each test period.ConclusionsThe patient manifested signs and symptoms of complex regional pain syndrome type I per the prior neurologic diagnosis, as well as the newly diagnosed accommodative infacility, accommodative insufficiency, convergence insufficiency, and deficits of saccades and pursuits, which were severely debilitating. The findings neither support nor refute the conventional notion of abnormal sympathetic mediation as a mechanism of fatigue and pain. However, the diagnoses of accommodative infacility and insufficiency suggest abnormal parasympathetic activation. Further investigation is needed to characterize the array of visual dysfunctions in a large sample of such patients, which may help elucidate the precise underlying neurologic causes of the sensorimotor deficits in these patients.

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