Cause of enophthalmos in Horner's syndrome

  • In Horner’s syndrome, enophthalmos is apparent, not real
    • It cannot be demonstrated using an exophthalmometer
  • Mechanism:
    • The underlying cause is damage to sympathetic nerves (cervical sympathetic trunk or central sympathetic pathway)
    • The upper lid drops down (ptosis) – due to paralysis of muller’s muscle (a part of levator palpebrae superioris)
    • Lower lid is pulled up – due to paralysis of smooth muscle responsible for retraction of lower lid
    • This causes narrowing of palpebral fissure causing an apparent enophthalmos

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Horner's syndrome

Horner's syndrome is a condition caused by damage to the sympathetic nervous system (cervical sympathetic chain or central pathways) Clinical...