Ptosis with Acquired Horners
Horner's syndrome or Horner syndrome is a clinical syndrome caused by damage to {the} sympathetic nervous system. It is also known by {the} names Bernard-Horner syndrome or Claude Bernard-Horner syndrome or as oculosympathetic palsy.
- Signs found in all patients on affected side of face include ptosis (drooping upper eyelid from loss of sympathetic innervation to {the} Müller or superior tarsal muscle, upside-down ptosis (slight elevation of {the} lower lid), and miosis (constricted pupil) and dilation lag.
- Enophthalmos ({the} impression that {the} eye is sunk in) and anhydrosis (decreased sweating) on {the} affected side of {the} face, loss of ciliospinal reflex and blood shot conjunctiva could occur depending on {the} site of lesion.
- Also flushing of {the} face is common on {the} affected side of {the} face due to dilation of blood vessels under {the} skin.
In children Horner syndrome often leads to a difference in eye color between {the} two eyes (heterochromia). This happens because a lack of sympathetic stimulation in childhood interferes with melanin pigmentation of {the} melanocytes in {the} superficial stroma of {the} iris.
Pathophysiology
Horner syndrome is due to a deficiency of sympathetic activity. The site of lesion to {the} sympathetic outflow is on {the} ipsilateral side of {the} symptoms. The following are examples of conditions that cause {the} clinical appearance of Horner's syndrome:
- First-order neuron disorder: Central lesions that involve {the} hypothalamospinal pathway (e.g. transection of {the} cervical spinal cord).
- Second-order neuron disorder: Preganglionic lesions (e.g. compression of {the} sympathetic chain by a lung tumor).
- Third-order neuron disorder: Postganglionic lesions at {the} level of {the} internal carotid artery (e.g. a tumor in {the} cavernous sinus).
If someone has impaired sweating above {the} waist affecting only one side of {the} body, yet they do not have a clinically apparent Horner's syndrome, then {the} lesion is just below {the} stellate ganglion in {the} sympathetic chain.
Neurologic conditions associated with Ptosis
- Horner's syndrome
- Heterchromia (iris)
- Home
- Anophthalmos
- Blepharoplasty
- Blepharospasm
- Brow Lift
- Congenital
- Dry Eye
- Eyelid Laxity
- Face
- Infections
- Inflammation
- Lacrimal System
- Lagophthalmos
- Latisse
- Locate an MD
- Orbital Tumors
- Ptosis
- Skin Rejuvenation
- Skin Tumors
- Symblepharon
- Thyroid
- Trauma