Collier's sign

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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]


  1. ^ "Colliers sign". 
  2. ^ a b c Larner, Andrew J. (2010). A Dictionary of Neurological Signs. Springer Publishing.  (subscription required)
  3. ^ J. Collier, Nuclear Ophthalmoplegia with special reference to retraction of the lids and ptosis and to lesions of the posterior commissure. Brain (journal) 1927; 50; 488 - 498.
  4. ^ a b Wray. "Supranuclear Paralysis of Upgaze". 
  5. ^ Miyashi M et al., Rinsho Shinkeigaku. 2006 Oct;46(10):712-4