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Old 08-31-2006, 06:11 AM   #1
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Unhappy Re: Horner's syndrome after cervical fusion

I also had a cervical fusion at c5-6. When I got home I looked in the mirror and couldn't believe what I saw. My rt eye is droopy and covers part of the pupil which compromises my vision. The a.m. is worse. It has been 2 months now since the fusion. and I have no improvement in the vision or droopy eye. My doctor said to give it a year. A whole year....I can't see out of that eye. Does anyone know how or if this will correct itself. The surgeon said he would send me to a plastic surgeon but if it comes back then it will be over compensated. Help!

 
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Old 09-06-2006, 09:06 AM   #2
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Re: Droopy eye after ACDF

Hi FL, i hope you pop back in to check this,you were accidently locked.but i really wanted to answer your post as i too have horners syndrome.it is actually caused by damage to the sympathetic nervous system.mine was damaged when my NS had to go into my actual spinal cord to remove what was basically a little glob of blood vessels that kept oozing blood from time to time.

somewhere,while your NS was inside your spine area,he hit the sympathetic nerve or the sns chain that runs down along both sides of the actual spinal column.this just happens sometimes when you are doing surgery that close to it.

from what you described,yours must have happened almost immediately since it was apparent when you got home from the hospital?how many days was that?mine didn't actually 'present" til about two and a half weeks post op while i was in the rehab hosp i had been transferred to for acute rehab on the things i had lost that i knew were going to be lost(that was the worst part of my surgery as i knew going in i was going to suffer a rather significant loss in my legs and the fine motor function in my hands).

anyways,the same thing happened to me when i just happened to look into the mirror one night when i went to brush my teeth and noticed something just didn't 'look' right about my eyes.the light above was not bouncing off of them evenly?so i took a closer look and lo and behold,i had one huge pupil on the right and my affwected eye was very very constricted.having worked in EMS for many years i knew this was not good at all.i just assumed i had developed a spinal fluid leak or was having a flippin stroke or some problem with the pressure inside my skull or cord.i KNOW how scarey THAT little discovery was for you,believe me.

after i saw my physiatrist(rehab doc)i was told only that this was being caused by "nerve damage".they didn't tell me it was from my sns being hit during surgery.

the really wierd thing about this is while i have the affected left eye lower lid that droops,my right eye has a very pronounced upper lid droop as well.in all the research i have donme on this i have seen nothing about both eyes being affected like this.and as far as resolving itself thats kind of an iffy thing at best.in order for this to resolve,whatever has affected that part of the SNS would also have to be resolved.it all depends on just what is the actual culprit here.something is either compressing the sns or it has been damaged like mine.

from what my NS told me,mine is most likely permanent.i am wondering about the complete loss of vision you have tho,that isn't really the norm.is the loss because you have the lid blocking your vision or is this an actual loss of your vision?while one would be part of the horners,the other would or could be caused by some other possibilities that could include damage to the optic or opthamologic(now i know i spelled that wrong) nerve.there are a few cranial nerves that come down from the head and go into the c spine area and junction at the c 8 nerve level,then loop back up into the head again,so it is entirely possible to actually suffer some sort of head,brain issues from damage done to the c spine area.


all i can tell you about the resolution of this is what i mentioned before,if the compromised nerve is no longer compromised.in my case,there is permanent damage.do you have any other symptoms like sweating on only half of your face?i am finally getting some sweating back in my whole face again but this has been almost three years since the onset for me.but that left pupil is still very constricted.

if i were you,i would give it some time to se what does come back and if that year or even about six months,that lid is still obscuring your vision,i would seriously consider some plastic surgery to get it back to looking normal again.

i really do feel for you with this,it does make you look a bit odd.like we haven't suffered enough already huh?are you also suffering any effects fromt he SNS damage itself?i have orthostatic hypotension which is kinda good for me as i also have a kidney disease and one of the big things i need to watch is for high blood pressure.so having my BPs lower because of the SNS damage really does help in that regard(at least something positive came out of a nightmare surgery from hell anyway)but this can also affect your heart rate too and the rhythems.it all depends on what is actually affected.just the actual SNS or also the para sympathetic as well.

if you look up info on the SNS and the para SNS you will get an idea of just what these systems govern and can kind of compare the symptoms you may be having but don't know why? this is what i had to do with all the seperate damage i have from my surgery.its alot and in many seperate areas.3 spinalnerves were damaged,my c 8 nerve(the ulnar) took the biggest hit out of the actual nerves,but then there are three seperate spinal tracts that also were damaged which have effected a whole lot of many many body system functions and neuro crap. then of course,the SNS damage which as you know has its own way of showing itself.

all you can do unfortuently is wait to see what happens.you are still pretty "fresh' from the actual surgery and alot could change over the next few months for you.but i would definitely wait to actually do anything sugical til you know pretty much for sure just what is and is not going to actually change with you.i know this all sucks,believe me,just try and get thru the next few months as best you can.

was the actual surgery a success tho?did it resolve the problem you were trying to solve?i certainly hope so after all this.please keep me posted on how things are going with you,K? i wish you lots of luck with this.marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 09-21-2006, 04:03 PM   #3
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Re: Droopy eye after ACDF

Hi FB,
Thanks for the post. Nothing has changed since I posted my message. The surgery was a sucess...I had a terrible pain over my left shoulder blade for a number of years and no one could figure out why until the NS found the disc that was giving me the pain. They would do triger pt injections and epidurals to no avail. They called it myofacia (spell) pain. I wore a tens unit every night just to kill the pain. The NS finally found the disc on the MRI. That is gone. The horner's was there right away when I came to after surgery so it did happen during the proceedure. Tomorrow I am seeing a plastic surgeon. Maybe I will find out my options and what it really is because from what I have researched on the web it is rare. Lucky me! I do not have any sweating on that side of my head...not just the face. I was told that's not good either because that is how our bodies cool off. The only real problem besides my looking like I have been on something is the vision. I am seeing my eyelashes and the pupil isn't dialated so it is like a camera lense...the imagine isn't getting through. To view my computer I put on my "cheater" glasses and have get within 8" of the screne. This is realllllllllly bumming me out. I get headaches above the eye because I try to lift it to see. I really think this is a permanent thing. My neurologist sent me to have all kinds of MRI's to make sure nothing else was going on. It isn't. This dr and the NS work together. The NS is young and supposed to be one of the best in our state and this has never happened to any of his patients before. He feels really bad and I don't blame him for this. I guess it was luck of the the draw.
It sounds like you have had your share of troubles too. Mine is just one of a whole list of surgeries. 15 alone on my right dominate hand. Oh well. Guess we have to be like the engerizer bunny and just keep going.
I will post again after I see the plastic surgeon. Thanks again for your time and post.

 
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