Question

a 50-year-old man presents with a 2-week history of not being able to see well. he is not on any medications. he has a 60 pack-year history of cigarette smoking. past medical and surgical history are otherwise unremarkable; he does not take any medications. on examination of his right eye, both ptosis and miosis are noted. a chest x-ray shows a rounded opacity in the right lung field.

Answer 1

The most likely diagnosis is Horner Syndrome.

Horner syndrome is a rare condition classically presenting with partial ptosis (drooping or falling of the upper eyelid), miosis (constricted pupil), and facial anhidrosis (absence of sweating) due to a disruption in the sympathetic nerve supply. Horner syndrome is primarily acquired following damage to the sympathetic nerve supply, but rare cases of congenital forms have been seen.

Learn more about Horner syndrome here:

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