Internuclear ophthalmoplegia is the inability of eye to adduct properly. Normally when we look towards an object both eye balls move towards that side in a conjugate lateral gaze. But in INO the effected eye is not able to cross the center point when looking towards the opposite side and also causes nystagmus of contralateral eye. This is caused by lesion in the medical longitudinal fasciculus which is a collection of nerve fibers from all cranial nerves III, IV and VI in the brainstem. The condition can be unilateral, bilateral or wall eyed bilateral (occurs when looking towards the wall). Diagnosis is usually clear on examination and Scan is only required to pinpoint the cause for management.