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Horner Syndrome

Iain W. Decker, D.O. and Omar B Saeed, MPH, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A constellation of neurological signs and symptoms manifested as a classic triad of ipsilateral miosis, eyelid ptosis, and anhidrosis of the ipsilateral face and/or neck (with iris h...

DIAGNOSIS

HISTORY

  • When did symptoms begin? (acute vs. chronic?)

  • Any visual symptoms? (blurred vision, field loss, transient visual loss, diplopia)

  • Previous ophthalmic history? (eye trauma, surgery, etc.)

  • ...

TREATMENT

GENERAL MEASURES

Once life-threatening etiologies have been excluded, cosmesis or functional vision impairment due to ptosis may be addressed if symptoms have persisted for 12 months. 

MEDICATION

ONGOING CARE

PROGNOSIS

  • Postganglionic: usually benign

  • Central and preganglionic: poorer prognosis

COMPLICATIONS

  • Chronic pupillary constriction

  • Cosmesis

REFERENCES

1
Chen Y, Morgan ML, Barros Palau AE, et al. Evaluation and neuroimaging of the Horner syndrome. Can J Ophthalmol. 2015;50(2):107–111. 
2
Antonio-Santos  AA, Santo  RN, ...

CODES

ICD10

  • G90.2 Horner’s syndrome

  • S14.5XXA Injury of cervical sympathetic nerves, initial encounter

SNOMED

  • 12731000 Cervical sympathetic dystrophy (disorder)

  • 271730003 Horner’s syndrome pupil

  • 212239002 Ce...

CLINICAL PEARLS

  • Horner syndrome triad: ipsilateral miosis, eyelid ptosis, and anhidrosis caused by a lesion of the oculosympathetic pathway

  • Red flag: Horner syndrome in the presence of acute-onset, ips...

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