Controversy has developed on the question of whether RSD can spread from one part of the musculoskeletal system (like an arm or a leg) to another part (like a different arm or leg). On one side of the camp, patients feel quite strongly that spread is a common occurrence. The opposite camp, usually physicians, feels that RSD does not spread and that it presents as a localized syndrome affecting the hand or upper extremity. Like most debates that have extreme points of view, the truth probably lies somewhere in the middle.

Ophthalmic, cardiac, hormonal, and dental system involvement should be carefully considered as a complication of Reflex Sympathetic Dystrophy (RSD). While controversy exists about this statement, basic facts concerning anatomy and physiology support the conclusion. In addition, clinical presentations occur where ophthalmic, cardiac, hormonal, or dental systems become involved, and the only discernable etiology for their involvement was the pre-existence or RSD.

Due to the autonomic innervation of the eye, patients with RSD not uncommonly complain of difficulty with dry eyes or blurred vision. In some instances accommodation, the eye’s ability to focus on images at varying distance is impaired. In others, the tearing mechanism is altered. Pupilary function can become sluggish as well. While these problems may wax and wane in concert with exacerbations and remission of pain, there does not need to be a direct correlation.