Horner syndrome is an uncommon but important clinical entity, representing interruption of the sympathetic pathway to the eye and face. Horner syndrome is almost always diagnosed clinically, though pharmacological testing can be used to confirm the diagnosis. Imaging modalities such as PET, CT and MRI are important components of workup for patients presenting with acquired Horner syndrome.

Our patient’s presentation with Horner syndrome unmasked the causative superior sulcus squamous cell carcinoma and a coincidental lower lobe adenocarcinoma. Successful radical treatment of these cancers resulted in complete resolution of the syndrome and disease-free survival at 18 months. We review the anatomy and pathophysiology underlying this and other causes of Horner syndrome.

Figure 1. Horner syndrome with classical features of partial ptosis,
apparent enophthalmos and miosis.

Key words: Horner syndrome, miosis, ptosis, superior pulmonary sulcus tumour, sympathetic nervous system

Clin Exp Optom 2007;90:336-344
Accepted for publication: 23 March 2007

* Yu X Kong MBBS BMedSci
* Gavin Wright MBBS FRACS
† Konrad Pesudovs BScOptom PhD FAAO
§# Justin O’Day MBBS FRACS FRANZCO AM
§ Zoe Wainer BMBS BHealthSci
§ Harrison S Weisinger MScOptom MBBS PhD
* Cardiothoracic Care Centre,
§ St. Vincent’s Hospital, Fitzroy, Victoria, Australia
† NH&MRC Centre for Clinical Eye Research, Department of Ophthalmology, Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia
# Department of Neuro-ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia

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