Internal Medicine Flashcard
Right eyelid droop

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Case description

A 59 year-old female with history of hemithyroidectomy for a benign lesion presented with 1 year of drooping of the right eyelid and anhidrosis of the right side of her face. She denied neck pain or trauma. Examination revealed ptosis of the right upper eyelid and miosis of the right pupil that was worse in dim light conditions (Fig. 1A). Thirty minutes after instillation of 0.5% apraclonidine in both eyes the ptosis resolved and the right pupil became larger than the left pupil. What is the

Discussion

This patient demonstrates the classic triad of ptosis, miosis, and anhidrosis characteristic of Horner syndrome. Horner syndrome is caused by a lesion of the oculosympathetic nerve pathway and is subdivided into central, preganglionic, and postganglionic depending on the location of the lesion. Central lesions occur anywhere between the hypothalamus and the ciliospinal center of Budge at C8-T1 in the spinal cord and can be due to infarction, trauma, demyelination, hemorrhage, or mass lesions. A

Declarations of Interest

None.

Acknowledgement

This research did not receive any specific grant from funding agenices in the public, commercial, or not-for-profit sectors.

References (3)

  • I. Davagnanam et al.

    Adult Horner's syndrome: a combined clinical, pharmacological, and imaging algorithm

    Eye (Lond)

    (2013)
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