Author Affiliations: Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Because of issues regarding their methodology and generalizability, we disagree with Smith and colleagues’1 conclusion that our recommendation2 that children with Horner syndrome of unknown etiology undergo urine screening and imaging be reappraised.
Seven of their patients were labeled as idiopathic, and 7 congenital cases were attributed to birth trauma, but a thorough investigation was either incomplete or not done in these cases, making it possible that another underlying process was missed.
Liu GT, Mahoney NR, Avery RA, et al. Pediatric Horner Syndrome. Arch Ophthalmol. 2011;129(8):1108–1109. doi:10.1001/archophthalmol.2011.201
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