MLF syndrome – Internuclear Ophthalmoplegia

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MLF syndrome, Internuclear ophthalmoplegia (INO), is a disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction. When an attempt is made to gaze contralaterally (relative to the affected eye), the affected eye adducts minimally, if at all. The contralateral eye abducts, however with nystagmus. Additionally, the divergence of the eyes leads to horizontal diplopia. That is, if the right eye is affected the patient will “see double” when looking to the left, seeing two images side-by-side. Convergence in MLF syndrome is generally preserved. In other words (When the normal eye looks to the right, the affected eye does not follow it, therefore remains in the center. This will also cause nystagmus of the normal eye since it gets confused and it does not know whether to stay on the right or go back to the center like the affected eye.)
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