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Horner syndrome
Neuro-Ophthalmology
Key Points
- •Horner syndrome triad: miosis + partial ptosis (1–2 mm) + anhidrosis; distribution of anhidrosis localizes the lesion to 1st, 2nd, or 3rd order
- •Acute painful Horner = carotid artery dissection until proven otherwise - neurovascular emergency requiring urgent CTA/MRA
- •Apraclonidine 0.5–1% is the most practical confirmatory test (reversal of anisocoria); hydroxyamphetamine 1% differentiates 3rd-order from 1st/2nd-order lesions
- •Congenital Horner produces iris heterochromia (lighter iris) - pathognomonic; always exclude neuroblastoma in children (urine VMA/HVA)
- •Anisocoria greater in darkness (dim light) = sympathetic defect (Horner); anisocoria greater in light = parasympathetic defect (Adie pupil or CN3 palsy)
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations