What can be done to treat Horner's syndrome? (photos)

I posted a question about a year ago regarding my right eyelid being droopy. I did a lot of research and I finally went to an ophthalmologist who confirmed I have Horner's Syndrome. I'm going to see a neurologist in a couple of weeks, but I wanted to know if any doctors came across a patient with horners syndrome that they were able to help. My opthamologist recommended Botox to lift my right eyebrow, but I'm doubtful this would help me achieve a symmetrical look.

Doctor Answers 5

Ptosis from Horner's Syndrome

Hopefully there has been a thorough workup for this problem. If there is nothing concerning as the cause of this, surgery is the best way to help this. The problem is in the eyelid and Botox will only minimally help by raising the eyebrow.


Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Ptosis surgery for Horner's

You can consider micro-ptosis surgery via a posterior approach (under surface of the eyelid). By improving the right eyelid position there will be no compensatory frontalis muscle  overaction causing eyebrow asymmetry and left upper eyelid retraction. 

Costas Papageorgiou, MD, FACS
London Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Horner's syndrome

Thank you for your question Lquinn724. Horner's syndrome is a neurological condition characterized by pupil constriction (miosis), a droopy eyeid (blepharoptosis), and dryness or decreased sweating (anhidrosis). Botox can be used to elevate a droopy eyebrow, but not a droopy eyelid. Sometimes a side effect of Botox is a droopy eyebrow, which is treated with apraclonidine (Iopidine) 0.5% ophthalmic solution. Treatment for Horner's syndrome is best addressed by a neurologist. Please consult with a neurologist for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Droopy eyelid secondary to horners syndrome

I would see a neuro-ophthalmologist to confirm the horners syndrome and to localize where the problem is, this can usually be found with drops in the eye. I would not recommend Botox for this because it is a problem of the sympathetic nervous system. This nerve innervates a muscle called muellers muscle which raises your eyelid 2mm and also dilates your pupil(you will notice your pupil in that eye is smaller than the other if you have horners syndrome). I usually put my younger patients with his on Iopidine eye drops which stimulate this muscle making your eyelids equal. On adults I perform a surgery called a muellerectomy which permanently raises the eyelid. This is a neat procedure done from underneath the eyelid so there is no scar.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Horner's syndrome

Thanks for your question. As you know, Horner's syndrome causes ptosis (a droopy eyelid), miosis (a constricted pupil) and anhidrosis (loss of sweating on one side of the face) caused from interruption of function of a nerve pathway.  Once a thorough evaluation on the cause of Horner's syndrome has been performed, ptosis repair is an option. There are techniques that are particularly effective for the ptosis seen in Horner's syndrome.I'd recommend seeking a consultation with an oculoplastic surgeon for an evaluation. Best of luck.

Chaneve Jeanniton, MD
Brooklyn Oculoplastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.