Medi Photos: Appearance of Sunset sign in infant eyes

The sclera are visible between the upper eyelid and the iris,Sunsetting sign is seen usually in hydrocephalus due to loss of upward conjugate gaze caused by raised intracranial pressure (ICP)

The setting-sun phenomenon is an ophthalmologic sign in young children resulting from upward-gaze paresis. In this condition, the eyes appear driven downward, the sclera may be seen between the upper eyelid and the iris, and part of the lower pupil may be covered by the lower eyelid. Pathogenesis of this sign is not well understood, but it seems to be related to aqueductal distention with compression of periaqueductal structures secondary to increased intracranial pressure.
However, it can also be transiently elicited in healthy infants up to 7 months of age by changes of position or removal of light (benign setting-sun phenomenon). The benign form might represent immaturity of the reflex systems controlling eye movements.

When persistent, this sign is one of the most frequent markers of elevated intracranial pressure, appearing in 40% of children with hydrocephalus (whatever the cause of Hydrocephalus as obstructive, communicating, Dandy-Walker anomaly/syndrome) and in 13% of patients with ventriculoperitoneal shunt dysfunction. It is an earlier sign of hydrocephalus than enlarged head circumference, full fontanelle, separation of sutures, irritability or vomiting. Consequently, this sign is a valuable early warning of an entity requiring prompt neuroimaging and urgent surgical intervention.

Synonyms

baby, Downward deviation of eyes, Downward Ocular Deviation, EYE DEVIATION DOWNWARD, infant, Infant (person), Infant child, Infant child (person), Infants, Manifestation Neurologic, Manifestation Neurological, MANIFESTATIONS NEUROL, Manifestations Neurologic, Manifestations Neurological, neural manifestation, NEUROL MANIFESTATION, NEUROL MANIFESTATIONS, NEUROL SIGNS SYMPTOMS, neurologic manifestation, Neurologic Manifestations, Neurologic manifestations of general diseases, Neurologic Signs and Symptoms, Neurological Manifestation, Neurological Manifestations, Sunset Sign

7 comments:

dDecember 4, 2012 at 6:38 AM
does a sunset sign indicate any abnormality in 3rd cranial nerve?
SamuelApril 23, 2015 at 12:40 AM
yes it does, raised ICP compressing cranial nerves 3,4,5
UnknownJune 15, 2015 at 5:30 AM
discripe from which area cranial nerve 3.4.5 can get pressure over
UnknownJanuary 30, 2019 at 9:54 AM
What is the treatment of sunset sign if the child is just 2 months old?
UnknownSeptember 9, 2019 at 3:01 PM
If the baby does it once or twice a day is this mean he has fluid in the brain
FidaSeptember 28, 2019 at 8:35 AM
When your baby got sun setting, and you already know that there is extra fluid in his brain and diagnosed with ventricolomegaly.. is that he suffer for loss vision? Or it can be cure?
JUKWAA LA AFYADecember 5, 2019 at 6:31 AM
It is helpful tool. Congrats