@article {George51, author = {N D L George and G Gonzalez and C S Hoyt}, title = {Does Horner{\textquoteright}s syndrome in infancy require investigation?}, volume = {82}, number = {1}, pages = {51--54}, year = {1998}, doi = {10.1136/bjo.82.1.51}, publisher = {BMJ Publishing Group Ltd}, abstract = {AIMS To evaluate whether isolated Horner{\textquoteright}s syndrome presenting in the first year of life warrants investigation. METHOD Retrospective review of 23 children presenting with Horner{\textquoteright}s syndrome in the first year of life. RESULTS In 16 patients (70\%) no cause was identified. Birth trauma was the most common identifiable cause (four patients). Twenty one children (91\%) had urinary vanillylmandelic acid (VMA) measured and 13 patients (57\%) underwent either computed tomography or magnetic resonance imaging of the chest and neck. These investigations revealed previously undisclosed pathology in only two{\textemdash}one ganglioneuroma of the left pulmonary apex and one cervical neuroblastoma. A further patient was known to have abdominal neuroblastoma before presenting with Horner{\textquoteright}s syndrome. There were no cases of Horner{\textquoteright}s syndrome occurring after cardiothoracic surgery. Long term follow up of the patients (mean 9.3 years) has not revealed further pathology. CONCLUSIONS Routine diagnostic imaging of isolated Horner{\textquoteright}s syndrome in infancy is unnecessary. Infants should be examined for cervical or abdominal masses and involvement of other cranial nerves. If the Horner{\textquoteright}s syndrome is truly isolated then urinary VMA levels and follow up in conjunction with a paediatrician should detect any cases associated with neuroblastoma. Further investigation is warranted if the Horner{\textquoteright}s syndrome is acquired or associated with other signs such as increasing heterochromia, a cervical mass, or cranial nerve palsies.}, issn = {0007-1161}, URL = {https://bjo.bmj.com/content/82/1/51}, eprint = {https://bjo.bmj.com/content/82/1/51.full.pdf}, journal = {British Journal of Ophthalmology} }