Horner's Syndrome of the Eye

Horner's Syndrome is a rare eye disorder caused by damage to the nerves in the cervical region of the body, which in turn causes an interruption in the neural pathways. It is a sign of another underlying problem and not a disease itself. Horner's syndrome generally only occurs on one side of the face and can affect any age, gender or race at any time. The prognosis depends on the underlying cause of the syndrome.

Understanding the Nerves

• The eye is controlled by nerves in the sympathetic and parasympathetic nervous system. These two systems control involuntary movement in the body. The nerves that control the eyes do not run in a straight line from brain to eye. They begin in the brain, run down through the spinal column, then back up through the chest and over the lungs, up through the middle ear and into the eye. Injury anywhere along this path can lead to Horner's syndrome.

Common Causes

• Horner's syndrome can occur for many reasons. It can be caused by stroke or brain tumors, spinal cord injury, lung cancer or an enlarged thyroid gland. It may also be caused by migraines, cluster headaches and inner ear infections. Anything that disrupts the nerve pathway to the eyes can cause Horner's syndrome. In some cases it can be congenital, meaning it occurs before birth.

Symptoms

• In Horner's syndrome, the upper eyelid of the affected eye droops and the lower eyelid swells, giving the eyeball a sunken appearance. The pupil is constricted and the iris may be a different color than the non-affected eye. The side of the face with the affected eye will not sweat. Additional symptoms depend on the type of injury and may help lead doctors to the underlying cause.

Diagnosis

• While a doctor can diagnose Horner's based on the symptoms and appearance of the eye, there are still several tests needed to confirm and look for the cause. Eye drops containing cocaine may be applied to the affected eye. The diagnosis is confirmed if the pupils do not dilate within 30 minutes. Other drugs may be applied to determine the location of the nerve damage. A chest x-ray determines if the cause is a lung tumor and an MRI looks for brain or spinal cord injuries.

Treatment

• There is no specific treatment for Horner's syndrome itself. Your doctor will focus on finding and treating the underlying cause. If the cause can be successfully treated, Horner's will clear up on its own. However, if you are having trouble seeing out of the eye, you may need to be monitored by an opthamologist.