Article Text
PDF
Statistics from Altmetric.com
A 62-year-old woman had noticed a droopy right eyelid for 2 weeks. She had a history of stage 2 breast cancer, treated 10 years before with mastectomy, radiotherapy and chemotherapy. She was otherwise healthy and took no medications. On examination, there was mild right upper eyelid ptosis and anisocoria, more pronounced in the dark, with the right pupil smaller than the left. Testing with 0.5% apraclonidine drops reversed the anisocoria (figure 1), and we diagnosed a right Horner’s syndrome.
(A) Right pupil is smaller than the left with mild right upper lid ptosis. (B) Forty-five minutes after instillation of 0.5% apraclonidine, there is resolution of ptosis and reversal of anisocoria, with the left pupil now larger than the right.
On further questioning, she reported a recent onset of pain along the right lower ribs. Given the previous history of breast cancer, we obtained a dedicated MR scan of the cervical and …
Footnotes
Contributors All authors contributed equally to the writing/revision of the manuscript and obtaining the data for the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed by Luke Bennetto, Bristol, UK.
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Copyright information:
Read the full text or download the PDF:
Other content recommended for you
- Nasopharyngeal carcinoma presenting as a sixth nerve palsy and Horner ’s syndrome
- Unequal pupils and ptosis
- Confirmation of Horner 's syndrome using apraclonidine eye drops
- Sudden onset of pain in the eye and blurring of vision
- The sensitivity and specificity of 0.5 % apraclonidine in the diagnosis of oculosympathetic paresis
- Eye drop neurology
- Eyelid ptosis from sympathetic nerve dysfunction mistaken as myopathy: a simple test to identify this condition
- Neuro - ophthalmological presentation of giant intracavernous carotid artery aneurysm in a child
- Patient use of Visine (tetrahydrozoline) masks Horner syndrome
- Diagnosis of Horner 's syndrome in dogs and cats