Horner' Syndrome


Horner’s Syndrome is a condition caused by some form of damage to
the sympathetic nerve supply to the eye.

The sympathetic nerve supply is only one of many different nerves that

control the eyes, but it is unique because of its path through the body. The
nerve supply travels from the brain, down the side of the spinal cord to
the chest and then travels all the way back up the neck to the eye.

This is quite extraordinary for a nerve, as most nerves travel in
the shortest possible distance to the area they control. The length
results in an increase risk of damage anywhere along its path.


There are 3 signs that characterize Horner’s syndrome,
enophthalmos (sunken eye and third eyelid protrusion),
ptosis (droopy upper eyelid) and
miosis (constricted pupil).

Additional signs such as
paralysis of front or hind limbs, head tilt, swelling near the eye, and
breathing problems may help to indicate the location of the nerve damage.


Symptoms to look for:
· Contraction of the pupil
· Two different sized pupils
· Visibility of third eyelid
· Drooping eyelids
· Sinking of eyelid into orbital cavity


Forms of damage may include:

Traumatic injuries to the neck
Middle ear infections
Surgical injury
Idiopathic neuropathies
(undiagnosed damage/degeneration of the nerve)
Tumours-growing and putting pressure on the nerve


Cats will generally have a specific problem, with a reported
incidence of 45% having the idiopathic form of the disease. In
contrast as many as 93% of dogs develop the idiopathic
neuropathy, for which a cause is not apparent. For this reason
many dogs can spontaneously recover over 3-4 months.


Diagnosis of the cause can include radiology (x rays of the head, neck
and chest), ultrasound examination of the area around the eye and
Cat-Scans of the head. These tests are only usually employed in
specific cases where other signs provide a clue to an underlying cause.


Treatment:
Treatment for Horner's Syndrome usually relies on treating the
underlying cause of the nervous system trauma. Depending on the
cause of the trauma this may include things like reducing
swelling of the nerves, removing the mass affecting the nerves,
treating a viral infection that is affecting the nerves

Eye drops containing phenylephrine are capable of temporarily
alleviating the signs.

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