– Slight elevation of the lower lid due to denervation of lower lid muscle. – Mild ptosis due to denervation of sympathetic nerve supply to Mϋller muscle. Dilatation of the pupil is slower after psycho sensory stimulus. – Miosis or constriction of the pupil in affected eye. Third order postganglionic pupillomotor fibers joins ophthalmic division of trigeminal nerve (Vth intracranial nerve) which innervates dilator muscle of iris and Mϋller muscle in the upper lid, via long ciliary nerves.ĭisruption of sympathetic pathway due to a lesion may lead to: Postganglionic vasomotor and sudomotor fibers innervate blood vessels and sweat glands of the face. Second order preganglionic pupillomotor fibers exit from thoracic level 1 (T1) and synapse in superior cervical ganglion at the cervical level 3 and 4 (C3-C4). First order neuron extend from posterolateral hypothalamus to ciliospinal center of Budge at cervical 8 to thoracic level 2 (C8-T2) in spinal cord. Sympathetic supply to the eye forms an arc of three neurons. Von Passow syndrome is an association of Horner syndrome with heterochromia iridis (different colour in parts of same iris). Horner syndrome (oculosympathetic palsy) is characterised by the classical triad of miosis (small and constricted pupil), partial ptosis (drooping of upper eyelid) and anhidrosis (loss of hemi facial sweating) caused due to disruption of sympathetic pathways.
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