I read with enthusiasm the excellent case series on pediatric Horner syndrome reported by Bacal and Levy.1 Young children with anisocoria are always a management dilemma because most cases are benign in nature but rarely a diagnosis such as neuroblastoma is made. Once the word is uttered, many parents are terrified and want some type of imaging study performed. Unfortunately a magnetic resonance imaging study from nearly head to toe is required to search for all possible locations of a neuroblastoma mass, and this procedure may have significant morbidity in young children and infants. A simple office test to confirm that the anisocoria is not due to Horner syndrome is therefore a very helpful tool for parental reassurance. Conversely, confirmation that the diagnosis definitely is Horner syndrome can stiffen the ophthalmologist’s spine regarding the necessity for urine testing and radiologic studies. This report therefore has great clinical value.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Ophthalmology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 3
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.