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Gorner's syndrome
Last reviewed: 04.07.2025

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An attentive person may sometimes notice a not quite proportional facial structure or something wrong with the eyes of passersby or a neighbor living nearby. It is quite possible that such a person is progressing with a disease called Horner's syndrome in medicine. The basis for the development of this disease is pathological changes affecting the human autonomic nervous system.
Causes Gorner's syndrome
This disease was first described by Johann Horner, from where it received its current name. The main causes of Horner's syndrome lie in the plane of symptomatic paths of development of some diseases.
These include:
- Neurofibromatosis type 1.
- Neoplasm according to Pancoast.
- Congenital changes affecting a bundle of nerve endings.
- Trigeminal neuralgia.
- Multiple sclerosis.
- Consequence of injury.
- Myasthenia gravis - a mutation of the gene responsible for the functioning of neuromuscular synapses.
- A neoplasm localized in the area of the hypothalamus, spinal cord and brain.
- Blockage of the veins of the cavernous sinus.
- Inflammation affecting the costal portion of the skeleton and/or the upper portions of the spine.
- Migraine pain.
- Frequent alcohol and other types of poisoning of the body (intoxication) can also lead to the progression of typical signs of Horner's syndrome.
- The consequence of a stroke is a hemorrhage in the brain.
- Syringomyelia is a chronic progressive pathology of the nervous system, as a result of which cavities form in the body of the spinal cord.
- Otitis is an inflammatory process localized in the middle ear.
- Aortic aneurysm.
- Increased thyroid parameters due to goiter. Simatectomy.
Symptoms Gorner's syndrome
Doctors voice several signs that may indicate the presence of this pathology in a person. It is worth noting that they may not be observed all together - in a complex, but only some of them. But there must be at least two such signs at the same time in order to be able to suggest the presence of the disease.
The main, most common symptoms of Horner's syndrome are:
- Miosis – a narrowing of the pupil of the affected eye is observed.
- Ptosis of the eyelids is a narrowing of the space between the upper and lower eyelids.
- Drooping of the upper eyelid, and less often, an increase in the lower eyelid can be observed.
- Reduced pupil response to external stimuli, specifically to a beam of light.
- In the case of the congenital type of the disease, young patients may have heterochromia of the iris. That is, uneven distribution of the color of the iris of the eye, its different coloring.
- A reduced amount of sweat production may be observed (facial localization on the side of ptosis), and the volume of tear substance also decreases.
- Half of the face on the affected side is hyperemic. The so-called Pourfur du Petit syndrome may also appear - a set of eye symptoms resulting from the irritating effect on the sympathetic nerve: mydriasis, exophthalmos, wide palpebral fissure, increased intraocular pressure, dilation of the vascular membrane and retina.
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Forms
Congenital Horner's syndrome
Today, doctors note a fairly noticeable increase in the number of diagnosed pathologies acquired by a person during the period of intrauterine development. Congenital Horner's syndrome is no exception. The most common cause provoking its development can be an injury received by the fetus during obstetrics.
In this form of the disease, ophthalmologists often observe an effect in which the iris of the newborn, and later of an older patient, does not acquire pigmentation, remaining grayish-blue. The eye's reaction to the introduction of special dilating drops is also reduced, which may indicate the presence of congenital Horner's syndrome in the newborn.
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Incomplete Horner's syndrome
But this disease may not have clearly expressed symptoms that even an amateur can notice. In this case, the disease in question can only be recognized by a certified specialist - at an appointment with an ophthalmologist, who will diagnose incomplete Horner's syndrome.
The symptoms of this type of disease are entirely determined by the level of changes and the extent of damage to the sympathetic structures.
Horner's syndrome in a child
As sad as it sounds, in addition to the congenital pathology that was already mentioned above, Horner's syndrome in a child can also manifest itself at a later stage of development.
At the same time, doctors note that if the disease began to manifest itself before the child is two years old, it is quite possible that such a pathology as heterochromia of the iris will develop, in which there is reduced pigmentation (or its complete absence) on the eye on the affected side of the face. The reason for such underdevelopment is explained by the lack of sympathetic innervation, which does not allow the production of melanocytes, which lead to the coloring of the iris of the eye in a certain color.
Paralysis of the optic sympathetic fibers may also have congenital roots, but be recognized only after many years. But the cause of the development of the disease in question may well be a surgical intervention performed on the baby's chest. For example, when correcting a congenital heart defect. A child may also get Horner's syndrome in the presence of other pathological changes in his growing body, or due to external factors that have already been mentioned in the causes of the pathology in question.
In some cases, doctors had to observe a paradoxically sharp reduction in the pupillary zone against the background of sudden darkness (the lights were turned off in the room), after which the pupil begins to slowly increase in size. At the same time, the response to external stimulation with a beam of direct light is close to normal. To date, the essence of this phenomenon is not fully understood by doctors. One option is an anomaly in the development of the retina or optic nerve.
Diagnostics Gorner's syndrome
Suspicions about the presence of the disease may arise both in the person himself or in the parents, if it concerns a child, and in the pediatrician or ophthalmologist at the next appointment. The doctor raises the issue of a specialized examination of the patient's body if at least two symptoms are present, from the signs listed above.
Diagnosis of Horner's syndrome includes a number of measures, which include:
- Testing the affected pupil with special eye drops based on cocaine. After instillation of the healthy organ, its expansion is observed. Such a reaction is caused by blocking the reverse clamp of norepinephrine. In the case of the presence of the disease in question, a deficiency of norepinephrine is observed in the synaptic cleft, which does not lead to the expected reaction, inhibiting the process.
- If the pupil is not dilated, 48 hours after the first test, the attending physician prescribes additional tests. This diagnostic step allows identifying the level of damage. A solution of hydroxyamphetamine (1%) is dripped into the pupil, which can be replaced by a 5% solution of p-methylhydroxyamphetamine. Based on the results of the reaction, a diagnosis is made: if there is a reaction to dilation, then a preganglionic type of damage is stated, but if such a pupil response is not observed, then a postganglionic type of Horner's syndrome is diagnosed.
- The patient will also have to undergo magnetic resonance imaging or computed tomography of the brain and spinal cord, upper spine. The doctor's choice of this or that study directly depends on the expected scale and depth of pathological changes.
- It may be necessary to conduct an X-ray examination, which will make it possible to detect a developing neoplasm and determine its location.
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Treatment Gorner's syndrome
Only after establishing the correct diagnosis can a qualified specialist prescribe treatment measures that, if not leading to a complete cure, will at least significantly improve the patient’s health situation.
The main focus of Horner's syndrome treatment is to activate the load on the nerve endings and muscle tissues of the affected eye. For this purpose, the patient is prescribed kinesiotherapy, in parallel with which myo- and neurostimulation is carried out.
The essence of the last method of influencing the changed organ comes down to the irritating effect of pulsed current on pathological tissues. In this case, nivation extends to absolutely all perceptible structures.
The method of myo-neurostimulation makes it possible to develop and adapt to further loads even those muscles that are very weak with a fairly high degree of efficiency. Such stimulation is carried out using skin electrodes through which the charge is supplied. This procedure is quite painful and is carried out under the direct monitoring of a qualified medical worker. But as a result, the patient is able to assess obvious improvements in the condition of the affected eye.
After the procedure, the following is observed:
- Activation of the outflow of lymphatic fluid from the diseased area.
- Improving blood flow.
- Stimulation and normalization of all metabolic processes.
- Increased muscle tone.
It is worth noting right away that after receiving this result, one should not stop there. After this complex treatment, a person should continue independent exercises designed to keep these muscles in normal working condition. For this purpose, specialists have developed a special complex called kinesiotherapy. It includes breathing exercises, therapeutic gymnastics, loads using exercise machines, various sports and applied competitions and active games.
But if all efforts do not lead to a positive result, the attending physician may decide to prescribe surgical intervention. This is possible in the case of excessive ptosis. Facial plastic surgery allows the patient to get rid of this defect caused by the disease in question. The plastic surgeon is able to completely restore the lost configuration of the eye slit, returning the patient to a healthy appearance.
Treatment of Horner's syndrome with folk remedies
It should be noted right away that, due to the lack of a deep understanding of the development mechanism of the pathology in question, self-treatment at home should not be undertaken. Treatment of Horner's syndrome with folk remedies can only be carried out as a supportive therapy and with the consent of the attending physician.
One of the simplest methods of therapy is the use of lifting creams, which can reduce the symptomatic manifestation of eyelid ptosis for a certain time. But even in this case, you should not prescribe it to yourself. This issue is especially relevant for patients prone to allergic reactions. In this case, you need to opt for hypoallergenic cream compositions.
In the treatment of Horner's syndrome with folk remedies, it is possible to use aromatic oils and masks that show a tightening effect. Massages are also suitable, but they should be performed by a specially trained specialist, or the patient should undergo an express course.
This article provides only a few masks that can be used to improve the cosmetic characteristics of the problem area.
- One of such compositions can be called a sesame-egg mask, which is obtained after mixing a thoroughly beaten yolk of one egg with a few drops (a couple is enough) of sesame oil. The resulting composition is applied in an even layer to the affected veto and left for twenty minutes, after which it is carefully washed off with warm water.
- Another mask also shows good results: wash the potato tuber and grate it. After that, place the resulting gruel in a cool place (a refrigerator will do) for a quarter of an hour. Then carefully distribute the potato pulp over the sore spot and let it “work” for twenty minutes. During this time, it is advisable for the patient to lie down. After the time has passed, wash off the medicinal composition with warm water, gently blotting off the excess with a napkin.
Regular use of these masks will not only improve the situation with the disease, but will also help get rid of small wrinkles around the eyes.
- Massages have also proven effective. Before the procedure, it is necessary to degrease and remove keratinized scales from the skin of the eyelid. Massaging movements should be done very carefully, using a cotton swab, to which a medicinal composition with antiseptic properties has been previously applied. This can be 1% tetracycline ointment, one percent solutions of sodium sulfacyl or synthomycin. It is possible to use other medications. Modern pharmacies offer the consumer a fairly wide selection of such drugs. The main thing is that they are prescribed by the attending physician. The movements should be light, stroking, with a little pressure, starting at the inner corner and ending in the outer area. Such procedures should be carried out daily for 10-15 days. The movements should alternate: from circular to rectilinear, with light patting.
Specialists have also developed exercises to increase the tone of the eye muscles. The exercises are performed standing up. All gymnastics is done with the eyes, without raising or turning the head. Each exercise is repeated six to eight times.
- With one eye we try to look as high as possible, then we quickly lower our eyes and try to look under our feet.
- We try, without turning our heads, to look first around the left corner, and then around the right corner.
- We strain our eyes by looking up and to the left, and then move our gaze diagonally down to the right.
- We strain our eyes by looking up and to the right, and then move our gaze diagonally down to the left.
- We begin the next exercise by stretching one hand in front of us and fixing our gaze on the index finger. Without tearing ourselves away from it, we slowly bring the phalanx to the tip of the nose. The image may double.
- Place the phalanx of the index finger on the bridge of the nose and look at it alternately with the right and then the left pupil.
- We make circular movements with our eyes, first in one direction, then in the other.
- Count silently, trying to hold out for 15 seconds, blinking your eyes vigorously. Take a short break and repeat the approach. And do this four times.
- We fix our gaze on a very close object, then move it as far as possible and fix it on a distant one. Again we return to the near one. And so several times.
- First, close your eyes tightly for five seconds, then open them sharply (hold for five seconds and close them again). Do ten of these approaches.
- With your eyes closed, begin massaging your eyelids with your fingertips in a circular motion. Continue the procedure for a full minute.
The amplitude of eye movement should be as large as possible, but pain symptoms should not be allowed to occur. A general course of exercises stimulating the tone of the eye muscles should be performed daily (two or three times a day is possible) for at least three months.
Prevention
As sad as it may sound, there are currently no absolutely effective methods that can prevent the occurrence and development of the disease in question. However, prevention of Horner's syndrome may consist in the fact that even with the slightest discomfort in the eye area or suspicion of a developing pathology, it is necessary to immediately consult an ophthalmologist, undergo a comprehensive examination and, if necessary, undergo a full course of treatment.
Only early and timely diagnosis and treatment can prevent further development of Horner's syndrome, preventing more severe forms of the pathology. It is this approach to one's health that increases the patient's chances of full recovery.
Forecast
The disease itself does not fall into the category of life-threatening diseases, but the whole problem is that its presence can indicate the presence of more serious deviations. Therefore, if the doctor suspects the disease in question, he prescribes a thorough examination for the patient.
It is the results of the conducted studies, early treatment and the timeliness of the measures taken that are in many ways the basic criteria that determine a reasonable prognosis for Horner's syndrome.
In case of embryonic development of the problem and emergency adequate treatment, a complete recovery is possible. But the most lasting result, of course, is given by plastic surgery.
As mentioned above, Horner's syndrome does not pose a health hazard to the affected organism. But this in no way means that the problem should be ignored and "given up on". Its manifestation may be the "tip of the iceberg" and indicate the presence of a much more serious pathology in the human body. If we consider this disease from the point of view of aesthetics, then not everyone is ready to tolerate such an ugliness on their face. Therefore, at the slightest discomfort, it is necessary to make an appointment with an ophthalmologist as soon as possible, who will confirm or refute suspicions and, if necessary, take effective measures. It is worth remembering that your health is in your hands!