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June 1980

Laser Application and Accommodation Paralysis

Author Affiliations

Stanford, Calif

Arch Ophthalmol. 1980;98(6):1133-1134. doi:10.1001/archopht.1980.01020031123026

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To the Editor.  —This is in reference to the letter of Ronald C. Pruett, MD (Archives 97:2212, 1979) commenting on the article of Gerald D. Rogell, MD, "Internal Ophthalmoplegia After Argon Laser Panretinal Therapy."In 1975, I first observed temporary accommodation paralysis in the right eye of a 19-year-old woman whom I treated with laser photocoagulation (argon laser, spot size 500 μ, 0.5 s, 150 mW, 394 lesions) for extensive myopic equatorial retinal degeneration. It was accompanied by moderate dilation of the pupil and sluggish pupillary reaction to light. The patient became acutely aware of her poor reading ability because she wore contact lenses that overcorrected her myopia. I attributed this phenomenon to damage to the parasympathetic nerve fibers innervating the ciliary muscle and iris sphincter. The condition resolved spontaneously within three months.I observed the same condition in both eyes of a 41-year-old woman treated with laser photocoagulation

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