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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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