[Pharmacological Tests for Horner Syndrome - Case Report]

Area of Science:

• Ophthalmology
• Neurology

Background:

• Anisocoria, a difference in pupil size, can indicate various neurological or ocular conditions.
• Horner syndrome is characterized by ptosis, miosis, and anhidrosis, resulting from disrupted sympathetic nerve pathways to the face and eye.

Observation:

• A patient presented with anisocoria (right pupil larger than left) for over a year, with a left-sided slight ptosis and left pupil dilation deficit.
• Ophthalmological examination revealed normal anterior and posterior eye segments, but a slightly decolored iris on the left.

Findings:

• The clinical presentation strongly suggested left-sided Horner syndrome.
• The underlying cause of the Horner syndrome remained unidentified.
• Pharmacological pupillary tests, crucial for diagnosing Horner syndrome, present current challenges.

Implications:

• The case underscores the diagnostic difficulties in identifying the etiology of Horner syndrome.
• It prompts a discussion on the limitations of standard diagnostic tests like the cocaine test.
• The report proposes alternative pharmacological tests using substances available in the Czech Republic for Horner syndrome diagnosis.