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Horner Syndrome in Children

Medically reviewed by Last updated on Oct 31, 2022.

What is Horner syndrome?

Horner syndrome is a nerve condition that affects one side of your child's face. The condition is caused by an injury to a nerve that controls that side of the face. Your child may have developed Horner syndrome during birth. Horner syndrome may be a sign of a serious condition such as a stroke or aneurysm. It is important to seek immediate care if your child develops other problems, such as head or neck pain.

What are the signs and symptoms of Horner syndrome?

  • Smaller pupil in one eye, and the pupil does not dilate (widen) well
  • Drooping upper eyelid, or a higher lower eyelid
  • The colored part of the affected eye may be lighter in color than the other eye
  • Less sweating on one or both sides of your child's face or in a small area on one side
  • Redness on the white part of your child's eye

How is Horner syndrome diagnosed?

Your child's healthcare provider will examine your child's eyes and face. Signs and symptoms may be enough for a diagnosis. Tell the healthcare provider about your child's symptoms, including when they began and if they have worsened over time. Tell the provider about your child's health conditions, such as cancer or a history of cluster headaches. The provider will also ask if your child had any recent injuries. Your child may also need any of the following:

  • Eyedrops may be used to check how well your child's pupils dilate. The drops may make the affected pupil larger or the unaffected pupil smaller.
  • X-ray, CT, or MRI pictures may help your child's healthcare provider find the cause of the nerve damage, such as an injury or tumor. Your child may be given contrast liquid to help problems show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.

How is Horner syndrome managed?

Treatment of Horner syndrome depends on the cause. Signs and symptoms usually go away if the cause can be treated. Your child may need any of the following:

  • An ophthalmologist (eye specialist) may be able to find and treat vision problems that develop. Your child's vision may not develop normally if the eyelid drooping is severe.
  • Occupational therapy may be helpful if your child has trouble seeing because of eyelid drooping. An occupational therapist can help your child strengthen affected eye muscles. The therapist can also help your child find ways to do school or daily activities more easily if he or she has vision problems.
  • Surgery or medication may be used if your child has severe eyelid drooping.

When should I seek immediate care?

  • Your child has head or neck pain.
  • Your child has sudden vision changes or problems.
  • Your child is dizzy or weak.

When should I contact my healthcare provider?

  • Your child has new or worsening signs or symptoms.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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