Collier's sign | |
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Symptoms | The sclera can be seen above the cornea, and further upgaze increases the distance between the eyelids and irises. |
Causes | Upper dorsal midbrain supranuclear lesions such as Parinaud's syndrome, 'top of the basilar syndrome', midbrain infarction, neurodegeneration or tumour, multiple sclerosis, encephalitis, and Miller-Fisher syndrome. Damage to the posterior commissure levator inhibitory fibres which originate in the M-group of neurons. |
Differential diagnosis | Midbrain lesion |
Collier's sign (also known as Collier's tucked lid sign[1] or posterior fossa stare[2]) is bilateral or unilateral eyelid retraction.
It is an accepted medical sign of a midbrain lesion, first described in 1927 by J Collier.[3] With the eyes in the primary position, the sclera can be seen above the cornea, and further upgaze increases the distance between the eyelids and irises.[4] Causes include upper dorsal midbrain supranuclear lesions such as Parinaud's syndrome, 'top of the basilar syndrome',[2] midbrain infarction, neurodegeneration or tumour, multiple sclerosis, encephalitis, and Miller-Fisher syndrome.[5] The cause is thought to be damage to the posterior commissure levator inhibitory fibres[2] which originate in the M-group of neurons.[4]
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