Right Eye Horner's Syndrome

This elderly male patient presented with chronic coughing associated with dyspnoea and weight loss. 

Examination noted partial ptosis of the right eye but no ophthalmoplegia.

Further examination of the eyes noted reduced pupil size over the right eye compared to the left eye. 

The left eye pupil size was normal.

A diagnosis of right Horner's syndrome was made. 

Respiratory examination noted bronchial breathing over the right lung apex with tracheal deviation to the contralateral side suggestive of a right pancoast tumour. 

Therefore the unifying diagnosis was Right pancoast tumour causing Right eye Horner's syndrome. 

CCE.