Features on the affected side:
- Miosis – small pupil
- Ptosis – drooping eyelid
- Anhidrosis – loss of sweating
- Enophthalmos – sunken eye (usually due to narrow palpebral fissure rather than true enophthalmos)
Answers: D (Horner’s) & A (Chest X-Ray)
Horner’s syndrome is due to an interruption of the sympathetic supply to the eye. Any lesion along the sympathetic supply’s course can potentially cause a Horner’s Syndrome. Two important causes worth remembering are:
- Pancoast Tumour: lung apex tumout which typically shows up on CXR or CT
- Carotid Artery Dissection: angiography (MRI or CT) are gold standard tests for detection or exclusion.