Clinical features
The clinical features of internuclear ophthalmoplegia can be roughly divided on a temporal basis:
Early features:
- slowing of adduction of the ipsilateral eye (due to paralysis of the ipsilateral medial rectus)
- exodeviation in lateral gaze to the side of the lesion
Later features:
- diplopia on lateral gaze
- failure of adducting eye to move beyond the midline on attempted lateral gaze
- abducting eye demonstrates a "coarse" or "ataxic" nystagmus during horizontal gaze
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