Dr. John oyer
West suburban eye care center,
396 Remington boulevard,
31 January 2017
Dear Dr. Dyer
Re: Mr tej Singh randhawa
DOB: 09 September 1976
Mr Randhawa , who was diagnosed with horners syndrome is being referres to an assessment and further management at your facility.
Mr. Randawa has attended our clinic thrice over the post three weeks, he has had several episodes of severe right sided headache.
He first presented on 10 january 2017 with complaints of a headache and rhinorrhoea . he was prescibed augmentine to treated with infectious sinus. Two weeks later complaints of severe headache right sided throbbing headache periodically relieved by test and hot pack . Additionally , rhinorrhea has persisted, the symptoms suggestive of a cluster headache. He was commrnced on a cetaminophen and non-steroidal anti - inflammatory medications.
On the last visit two days ago, with the complaints of headaches and rhinorrhoea and right eye droopy and sunken. Moreover , his wife reported his face flushed before and during headache. An examination revealed decreased sweating on the right side of his face and right pupil constricted in darkness.
Based on above information , Mr randhawa needed you as provide further treatment and management to overcome his present difficulties.
If you have further information please do not hesitate to contact me.
17. Mr Tej Singh Randhawa - Rajya Lakshmi - Soumya typing