Differential Diagnosis for Blurred Vision and Horner Syndrome
Single Most Likely Diagnosis
- Carotid Artery Dissection: This condition is a common cause of Horner syndrome and can also lead to blurred vision due to involvement of the ophthalmic artery or compression of the optic nerve. The dissection can cause an ipsilateral Horner syndrome and visual disturbances.
Other Likely Diagnoses
- Stroke or Cerebral Vasculitis: These conditions can cause Horner syndrome by affecting the sympathetic pathways in the brainstem or the carotid artery, and blurred vision if the visual pathways are involved.
- Cluster Headaches: Although primarily known for severe headaches, cluster headaches can be associated with Horner syndrome and blurred vision due to the involvement of the autonomic nervous system and possible compression of nerves supplying the eye.
- Multiple Sclerosis: This demyelinating disease can cause a wide range of neurological symptoms, including blurred vision (due to optic neuritis) and Horner syndrome (if the sympathetic pathways in the central nervous system are affected).
Do Not Miss Diagnoses
- Pituitary Apoplexy: A medical emergency where a pituitary tumor suddenly hemorrhages or infarcts, potentially causing sudden blurred vision, Horner syndrome (due to compression of nearby structures), and other acute neurological symptoms.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause Horner syndrome, blurred vision, and other neurological deficits due to the involvement of multiple cranial nerves and the carotid artery.
- Giant Cell Arteritis: An inflammatory condition that can cause blurred vision (due to ischemic optic neuropathy) and Horner syndrome (if the sympathetic nerves are involved), requiring prompt treatment to prevent permanent vision loss.
Rare Diagnoses
- Syphilis: Neurosyphilis can cause a variety of neurological symptoms, including Horner syndrome and visual disturbances, although this is relatively rare.
- Tolosa-Hunt Syndrome: A rare condition characterized by painful ophthalmoplegia, which can include Horner syndrome and blurred vision due to inflammation of the cavernous sinus or superior orbital fissure.
- Raeder Syndrome: A rare condition that presents with a triad of miosis, ptosis, and facial anhidrosis (Horner syndrome), along with facial pain, which can be associated with blurred vision in some cases.