Horner’s Syndrome with Ipsilateral Abducens Palsy in A Primary CNS Tumor

Case Report A 36 year old male presented with sudden onset binocular diplopia along with mild drooping of right upper lid, decreased sensation on right side of face and dryness in right eye for 2 months. There was no history of diminution of vision, ocular pain, headaches, seizures or trauma. Patient had no known chronic systemic illness. General and systemic examination was unremarkable. Ocular examination showed BCVA of 6/12 OD and 6/6 OS. Slight right face turn with reduced sensations on right side of face and forehead was noted. Mild ptosis with Margin Reflex Distance1(MRD1) of 3 mm OD was seen (Figure 1). Patient had right sided abduction deficit with orthotropia in primary position (Figure 2). Cornea was lusterless with few epithelial opacities and reduced sensations OD (Figure 3). Left eye was normal. Pupil examination showed anisocoria(OD=3mm,OS=4.5mm) with miosed pupil OD (Figure 3). Anisocoria decreased in bright light and with near response, showing an increase in darkness. Rest of anterior segment and fundus evaluation was normal.