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Horner syndrome

Oculosympathetic paresis

Horner syndrome is a rare condition that affects the nerves to the eye and face.

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Central nervous system and peripheral nervous system

Causes

Horner syndrome can be caused by any interruption in a set of nerve fibers that start in the part of the brain called the hypothalamus and travel to the face and eyes. These nerve fibers are involved with sweating, the pupils in your eyes, and the upper and lower eyelid muscles.

Damage of the nerve fibers can result from:

In rare cases, Horner syndrome is present at birth. The condition may occur with a lack of color (pigmentation) of the iris (colored part of the eye).

Symptoms

Symptoms of Horner syndrome may include:

There may also be other symptoms, depending on the location of the affected nerve fiber. These may include:

Exams and Tests

The health care provider will perform a physical exam and ask about the symptoms.

An eye exam may show:

Depending on the suspected cause, tests may be done, such as:

You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).

Treatment

Treatment depends on the underlying cause of the condition. There is no treatment for Horner syndrome itself. Ptosis is very mild and in rare cases affects vision in Horner syndrome. This can be corrected by cosmetic surgery or treated with eyedrops. The provider can tell you more.

Outlook (Prognosis)

The outcome depends on whether treatment of the cause is successful.

Possible Complications

There are no direct complications of Horner syndrome itself. But, there may be complications from the disease that caused Horner syndrome or from its treatment.

When to Contact a Medical Professional

Call your provider if you have symptoms of Horner syndrome.

Related Information

Ptosis - infants and children
Eyelid drooping

References

Balcer LJ. Pupillary disorders. In: Liu GT, Volpe NJ, Galetta SL, eds. Liu, Volpe, and Galetta's Neuro-Ophthalmology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 13.

Guluma K. Diplopia. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 18.

Thurtell MJ, Rucker JC. Pupillary and eyelid abnormalities. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 18.

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Review Date: 6/23/2020  

Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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