Sunset eye sign

Last revised by Daniel J Bell on 18 Apr 2019

The sunset eye sign (also known as the setting sun phenomenon) is a clinical phenomenon encountered in infants and young children with raised intracranial pressure (seen in up to 40% of children with obstructive hydrocephalus and 13% of children with shunt dysfunction 1). 

It consists of an up-gaze paresis with the eyes appearing driven downward. The lower portion of the pupil may be covered by the lower eyelid, and sclera may be seen between the upper eyelid and the iris.

It is presumably related to Parinaud syndrome and results from compression of the periaqueductal structures. 

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1 : with congenital aqueductal stenosis
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.