Collier's sign (also known as Collier's tucked lid sign or posterior fossa stare) is bilateral or unilateral

eyelid An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eyel ...

retraction. It is an accepted medical sign of a

midbrain The midbrain or mesencephalon is the forward-most portion of the brainstem and is associated with vision, hearing, motor control, sleep and wakefulness, arousal (alertness), and temperature regulation. The name comes from the Greek ''mesos'', " ...

lesion, first described in 1927 by J Collier.J. Collier, Nuclear Ophthalmoplegia with special reference to retraction of the lids and ptosis and to lesions of the posterior commissure. ''

Brain (journal) ''Brain: A Journal of Neurology'' is a peer-reviewed scientific journal of neurology, founded in 1878 by John Charles Bucknill, David Ferrier, James Crichton-Browne and John Hughlings Jackson. It is published by Oxford University Press. The jour ...

'' 1927; 50; 488 - 498. With the eyes in the primary position, the

sclera The sclera, also known as the white of the eye or, in older literature, as the tunica albuginea oculi, is the opaque, fibrous, protective, outer layer of the human eye containing mainly collagen and some crucial elastic fiber. In humans, and som ...

can be seen above the

cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical power ...

, and further upgaze increases the distance between the eyelids and irises. Causes include upper dorsal midbrain supranuclear lesions such as

Parinaud's syndrome Parinaud's syndrome is an inability to move the eyes up and down. It is caused by compression of the vertical gaze center at the rostral interstitial nucleus of medial longitudinal fasciculus (riMLF). The eyes lose the ability to move upward and ...

, 'top of the basilar syndrome', midbrain infarction,

neurodegeneration A neurodegenerative disease is caused by the progressive loss of structure or function of neurons, in the process known as neurodegeneration. Such neuronal damage may ultimately involve cell death. Neurodegenerative diseases include amyotrophic ...

or tumour,

multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...

encephalitis Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations, ...

, and Miller-Fisher syndrome. The cause is thought to be damage to the

posterior commissure The posterior commissure (also known as the epithalamic commissure) is a rounded band of white fibers crossing the middle line on the dorsal aspect of the rostral end of the cerebral aqueduct. It is important in the bilateral pupillary light refle ...

levator inhibitory fibres which originate in the M-group of

neuron A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa. N ...

References

{{med-sign-stub Medical signs