A Case of Horner’s Syndrome Following Partial Excision of an Inflammatory Neck Mass and Removal of Cervical Hardware

Objective: Horner’s syndrome (oculo-sympathetic paresis) is a neurological disorder characterized by miosis, ptosis, and anhidrosis due to the disruption of the sympathetic pathway. It rarely occurs as a complication of neck surgery. When this condition occurs, the patient is required to function with a unilateral ptosis and anisocoria. At present, no specific regimen is recommended for managing symptoms such as unilateral headache, diplopia, and asthenopia in patients with Horner’s Syndrome. This case evaluates the use of a combination of drops that provided temporary symptom relief, enabling the patient to carry out daily tasks. Case Presentation: We report the case of a 50-year-old female who developed right-sided Horner syndrome following neck surgery. The patient received ophthalmic treatment with Upneeq (oxymetazoline hydrochloride 0.1%) and brimonidine tartrate (0.1–0.2%) eye drops alongside management of associated dry eye symptoms. Discussion: Pharmacological intervention resulted in a temporary reduction in ptosis and miosis. Treating dry eye is essential to avoid keratitis, and other ocular surface issues. The sympathetic pathway is intricately involved in the mechanisms of tearing. Preventing the vicious cycle of dry eye syndrome is crucial. Patients who have neck surgery often recover well due to the work of their surgeons. However, It can be challenging to return to work when experiencing ptosis, anisocoria, and dry eye. Establishing an ocular drop regimen helps these patients resume their daily activities. Conclusion: Although rare, Horner syndrome can manifest postoperatively. Early diagnosis and tailored ophthalmic treatment, including sympathomimetics and the management of secondary ocular conditions, are crucial for improving patient outcomes and preventing long-term visual disturbances.