- Welcome
- Topic 1: Background of Ocular Sympathetics
- Topic 2: Elements of the Case History
- Topic 3: Clinical Tests
- Topic 4: Confirmatory and Diagnostic Tests
- Topic 5: Patient Education
- Topic 6: Treatment and Referral
- Conclusion
- HELP
Case 2
Read the following case, then move on to the next page
A patient entered the examination room with a complaint of sudden-onset right-sided headaches X 1 week. Upon intense questioning, the patient revealed that the headaches were severe, and sometimes woke the patient from sleep. The headache worsened upon bending over.
Entering visual acuity and manifest refraction were unremarkable. Chair skills were remarkable for subtle anisocoria (uneven pupil sizes), which increased under dim illumination. The right pupil was smaller than the left. Slit-lamp examination and dilated fundus examination were unremarkable.
The doctor diagnosed the patient with Horner’s syndrome, and referred him to a neurologist for an MRI.
Several weeks later, the neurologist sent back a report that described the presence of a tumor of the middle cranial fossa that was impacting the sympathetic nervous supply to the eye. The tumor was removed and the patient was recovering nicely.
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