Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 5-6, Pages: 312-314
https://doi.org/10.2298/SARH1606312K
Full text ( 367 KB)
The role of apraclonidine in Horner’s syndrome: A case report
Karadžić Jelena (Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade)
Kovačević Igor (Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade + School of Medicine, Belgrade)
Ljikar Jelena (Clinical Center of Vojvodina, Eye Clinic, Novi Sad)
Introduction. Horner’s syndrome is an interruption of the sympathetic nervous
system at any point along its course between the hypothalamus and the orbit.
Horner’s syndrome is classically presented as an ipsilateral miosis, subtle
ptosis, and facial anhidrosis. Pharmacologic testing is very useful in the
diagnosis of Horner’s syndrome as it could help to localize the lesioned
neuron in the sympathetic pathway, suggesting an etiology. Case Outline. We
present a case report of a 41-year-old woman who reported right eyelid
drooping immediately after operation of sympathetic chain schwannoma. We
performed apraclonidine test for the diagnosis of Horner’s syndrome, which
produced mydriasis on the affected eye, while there was no significant change
of the normal eye. Based on the clinical presentation of anisocoria and
one-sided ptosis, and previous medical history of surgical removal of the
mediastinal tumor, the patient was diagnosed with a right-sided, partial
Horner’s syndrome. Conclusion. Timely recognition, exact localization of the
lesioned neuron, and referral for urgent imaging studies are important for
ophthalmologists in order to prevent and treat life-threatening conditions.
Besides its diagnostic value in Horner’s syndrome, topical apraclonidine
could correct ptosis for the sake of esthetics or when ptosis reduces the
superior visual field.
Keywords: Horner’s syndrome, apraclonidine test, sympathetic chain schwannoma