Parinaud syndrome is characterized by Impaired upward gaze Lid retraction (Collier sign) Downward gaze preference (setting-sun sign) Convergence-retraction nystagmus Dilated pupils (about 6 mm) that respond poorly to light but better to accommodation (light-near dissociation) Downward gaze palsies Impaired voluntary vertical gaze, especially downward, with preservation of reflex vertical movements (doll's-eye maneuver) usually indicates progressive supranuclear palsy; other causes are rare.