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Apraclonidine has been shown to reverse the anisocoria in Horner’s syndrome, with some reports of partial ptosis resolution. Side-effects of apraclonidine have been reported especially in children under six months old. The authors present a retrospective safety study of using 0.5% apraclonidine eye drops in children suspected to have Horner’s syndrome. Results of the test, time observed, and any side-effects were documented. Forty-six children had apraclonidine eye drops instilled. The average age of the children using the mode was three months old and a range of seven-weeks to 15-years-old No topical or systemic side-effects were noted in any of the patients. Fifteen children underwent further investigation for Horner’s syndrome after reversal of anisocoria. The authors highlight limitations linked to the retrospective nature of this study, relying on documentation of side-effects. A prospective study is required to definitively assess the safety of apraclonidine use in children.

Safety of apraclonidine eye drops in diagnosis of Horner syndrome in an outpatient pediatric ophthalmology clinic.
Eldib AA, Patil P, Nischal KK, et al.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2021;25:336.
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CONTRIBUTOR
Lauren R Hepworth

University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.

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