What is the recommended management for Horner syndrome?

• A. Refer for neuroimaging
• B. Start steroid therapy
• C. Laser treatment
• D. Observation only

Answer: (A)

Horner syndrome signals disruption along the oculosympathetic pathway, and the priority is to uncover any underlying cause rather than just treat the eye signs. Because acquired Horner syndrome can be a clue to serious conditions such as carotid artery dissection or a Pancoast tumor, the appropriate next step is to obtain neuroimaging to locate and characterize the lesion driving the syndrome. This approach guides urgent management if a dangerous cause is found and prevents missing a potentially life-threatening condition.

Steroid therapy, laser treatment, or simply observing without imaging don’t address the root problem and could delay critical diagnosis. Imaging provides the information needed to determine the appropriate workup and follow-up.