Horner syndromeOculosympathetic paresis
Horner syndrome is a rare condition that affects the nerves to the eye and face.
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 some of the muscles around your eyes.
Damage of the nerve fibers can result from:
- Injury to the carotid artery, one of the main arteries to the brain
- Injury to nerves at the base of the neck called the brachial plexus
- Migraine or cluster headaches
A migraine is a type of headache. It may occur with symptoms such as nausea, vomiting, or sensitivity to light and sound. In many people, a throbbi...
- Stroke, tumor, or other damage to a part of the brain called the brainstem
- Tumor in the top of the lung
- Injections or surgery done to interrupt the nerve fibers and relieve pain (sympathectomy)
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 of Horner syndrome may include:
- Decreased sweating on the affected side of the face
- Drooping eyelid (ptosis)
Ptosis (eyelid drooping) in infants and children is when the upper eyelid is lower than it should be. This may occur in one or both eyes. Eyelid dr...
- Sinking of the eyeball into the face
- Small (constricted) pupil (the black part in the center of the eye)
There may also be other symptoms, depending on the disorder that is causing the nerve damage.
Exams and Tests
The health care provider will perform a physical exam and ask about the symptoms.
An eye exam may show:
- Changes in how the pupil opens or closes
- Eyelid drooping
- Red eye
Depending on the suspected cause, tests may be done, such as:
- Blood tests
- Blood vessel tests of the head (angiogram)
- Chest x-ray or chest CT scan
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
- MRI or CT scan of the brain
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
- Spinal tap (lumbar puncture)
You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).
Treatment depends on the cause of the problem. There is no treatment for Horner syndrome itself. The provider can tell you more.
The outcome depends on whether treatment of the cause is successful.
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.
Baloh RW, Jen JC. Neuro-ophthalmology. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 424.
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.
Central nervous system - illustration
The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.
Central nervous system
Review Date: 5/30/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.