- 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 7
Read the following case, then move on to the next page
A patient entered the clinic for a routine examination with no complaints. His history was unremarkable.
During the course of the examination, anisocoria (increasing in dim light) was noted, with the right eye having the smaller pupil. The IPD was 7mm OD, 10mm OS. Due to the possibility of Horner’s syndrome, 0.5% cocaine was instilled in both eyes, yielding marked pupil dilation OS, and mild pupil dilation OD. The patient was diagnosed with likely Horner’s syndrome.
Due to the chance of a life-threatening cause, the patient was referred to radiology for a chest and neck X-ray. The patient was told that he had Horner’s syndrome, which could be evidence of a potentially-life threatening condition, but that was often treatable. He was told that an X-ray would help determine the cause, which could likely be treated afterward, and that he should go to the radiologist Monday morning. The patient confirmed that he would keep the appointment, and did.
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